Member Application Form

The Hepburn Renewable Energy Association (HREA) was established and incorporated by a group of local residents. The Association believes that we, the community, can take responsibility for our own energy needs and at the same time help to protect our environment from climate change.

Hepburn Renewable Energy Association, 20 Bridport Street, Daylesford 3460

If you wish to discuss any matters relating to the Association or its objectives, please contact us . Thank you for your interest.

APPLICANT DETAILS

* Required fields
* First name * Last name
* Street Address:
* Suburb/Town: * State:
* Postcode:
* Telephone - Home Number Office Number
Mobile number:   Fax number:
* Email address:
Date:
   
(Please Note: Communications will be sent by email)

The Annual Subscription Fee is $10

Your Application will become effective on receipt of your $10 subscription fee.

The Association is also pleased to accept donations. I would also like to donate: $

Please deliver or post your Subscription Fee and any donation to :

Hepburn Renewable Energy Association Inc
20 Bridport St
Daylesford VIC 3460
or pay by direct transfer to:
Account Name: Hepburn Renewable Energy Association Inc
Bank: Bendigo Bank
BSB: 633108
Account No: 126473453
Comment: Your name

By submitting this Application, you apply to become a member of the Hepburn Renewable Energy Association ("the Association") and, in the event of your admission as a member, you agree to be bound by the Rules of the Association for the time being in force.

If I am admitted to membership of the Association I agree to be bound by the Rules of the Association for the time being in force.