Group Membership Renewal- Landcare Tasmania

Account Administrator for Landcare Tasmania - Private

Yes, Landcare Tasmania may contact me by email.

Name

Email (used to login to this account)*

Mobile

Phone*

Displayed on the "Find a Group" webpage

Municipality where Group most frequently works (or select "Statewide")*

Suburb where Group most frequently works (or "Statewide")*

Postcode where Group most frequently works (or "Statewide")*

Don't publish these details on the website

Public Contact Name*

Public Contact Email*

Public Contact Phone*

Regular events (Example: Working Bees 2nd Sunday of the month at ...)

Annual Membership Form Page 1/2