Aussie Connie Supporters Membership/Donation Form
Please print form and post/fax to the address above

You may contact the Treasurer, Mrs Maureen Massey on 0400 818 557 to discuss sponsorships involving 'Connie' or other HARS operated aircraft.

Name:
Address:
Telephone:
Facsimile:
E-mail:

I would like to become an Aussie Connie Supporter and receive Phoenix magazine quarterly to keep me informed. I enclose my first year's membership of $38.50.

I would like to ensure VH-EAG Southern Preservation regularly flies and enclose my tax deductible donation of $10, $25, $50, $100, $500 $...............................

If my donation is $100 or more I will receive an identity card and go to the head of the queue to inspect VH-EAG at air shows and open days.

I want to become a major sponsor ($5,000 or more) OR I would like to discuss marketing, advertising or promotions involving VH-EAG. Please send me details.

Please charge to my credit card:	Bankcard	Mastercard	Visa
Name on card:
Card Number:
Card Expiry date:
Home telephone number:
Cardholder's signature: