Deep Creek Landcare Group
(Covering Lancefield, Romsey & Monegeetta Districts)
ABN 79 178 521 485
PO Box 99, ROMSEY, VIC, 3434
Membership Application Form
Name……………………………………
Postal Address…………………………
…………………………………………...
P/Code……………………………...........
Tel……………………………………….. Property Name…………………………
Property Size……………………………
Email Address…………………..….......
……………………………………………
Date:……………………………………. Full Membership $20.00 (per property)
Associate membership $5.00
Junior (under 16 years) Free
All payments include GST & should accompany this form. Direct Debit – BSB 633 000 ACC 116655184
President: Phil Severs 0476 324 000
Secretary: Pat Danko : 0417103 064