Membership Form Complete and submit the Online Form below, or else click for the PDF version to print/mail. I wish to apply for membership of the Australian Federation of Graduate Women NSW Inc : Title (Ms, Miss, Mrs, Dr): Surname: Given Names: Home Address: Home Phone Number: Mobile Phone Number: Email: Details of your Degrees / Awards / Honours: Degree/Award/Hons Institution Year Applicable Surname My professional/general interests: I would like to join a Branch: Branch: Membership Fee: Full Membership Fee $40.00 / Associate Membership $25.00 – for the financial year 1 July to 30 June (If you join after 1st April, you will be financial until 30 June the following year) Tick if you require a receipt Tax deductible donations to the AFGW NSW Inc Education Trust may be included in your payment. Your generous donation assists AFGW NSW in supporting women in education. Receipts will be provided for all donations. My tax deductible Education Trust donation is: Cheques should be made payable and sent to: AFGW NSW Inc LG Floor, 280 Pitt St Sydney NSW 2000 Or Online Payment (include your details) to: ANZ Bank AFGW-NSW Inc BSB: 012 670 Account #: 300 706 398 Information provided to AFGW-NSW may be shared with AFGW Inc unless you specifically instruct the Membership Registrar otherwise. AFGW-NSW Inc and AFGW Inc will not make your information available to any other person or organization without your specific consent.