Membership Application form

First Name*:
Last Name*:
Gender:  Male Female
Address:
Suburb:
Postcode:
Email address*:
Phone number :
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Annual Membership Subscription fee of $25.00 is payable in advance at the beginning of fiscal year (January 2016).

EFT Details
Nepalese Community of Western Sydney
St George Bank
BSB: 112-879
Account Number: 46-476-1502