KNC Membership Application

Please enter information on the form below to process subscription for KNC Membership.

First Name *

Last Name *

Organisation

Address

Address2

Suburb *

Postcode *

Phone *

Email *

Comment

Date of Birth: *

Occupation: *

Reason/s for becoming a member: *

Would you like to make an additional donation to the Centre?

Other amount

Agreement *

I hereby apply to become a member of the above named association. In the event of my admission as a member, I agree to be bound by the rules of the Association for the time being in force and to pay the Annual Membership Fee as decided by the KDNC Board of Management.

Application Date: *

Payment Information

Price

Payment Method *

Offline Payment - (EFT or pay at the centre)

CREDIT CARD (Stripe)

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

I accept

Captcha*

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