Friends of Rotorua Museum Application

Title (Mr/Mrs/Miss/Ms) (required)

First Name (required)

Last Name (required)

Postal Address (required)

Your Email (required)

Phone (Home/Business) (required)

Phone (Cell)

Please tick appropriate category:
Individual Member $45Family/Double Membership $80Youth (18 years and under) $35Senior (65 years and over) $35

I would also like to make a donation:
Donation amount $

Total amount (required) $

ChequeDirect Credit

Please send your cheque to:
Friends of Rotorua Museum
PO Box 1736
Rotorua 3040

Bank details (Direct Credit)
Westpac 03 1552 0099250 00
Please quote your surname as reference

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