I /we declare that I/ we agree to the objects of the Association and to abide by it's Rules, and wish to
become a member/ members
Name(s)..........................................................................................
Address............................................................................Postcode..............
.................................................................................................
Phone:(H).......................................(W)..............................................
Email............................................................................................
Monthly newsletter by mail (default is email)?.....................
Type of membership..........................Amount enclosed: $.......................................
Permaculture Courses/qualifications?
Please circle any applicable and add where and year completed.
Not applicable..............Intro.............................. PDC............................... Diploma...............................Advanced/Other...............................
Where did you find out about PASA?.............................................................................
.................................................................................................
Membership Form - May 2005