Cunningham Library

Application for Library Membership - Individual

To complete the order, please enter your details below (All fields are required):

*Surname(Family Name):
*Given name:
Membership Number: (if this is a renewal)
*Postal Address:
*Suburb/town/city:
*State:	Please select Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Other
If Other State please specify:
Postcode:
*Country:	Please select Australia Other
If Other Country please specify:
*Telephone: Please provide area code
Fax:
*Email Address:
*Confirm Email Address:
Subscription cost level:	Australia $200 (to 31 Dec 2018) Outside Australia $184 (no GST) (to 31 Dec 2018)
	* denotes required field