Membership Application and Renewal Form Objectives of Women’s Space Association Inc.: Womenspace provides opportunities for women to educate and enrich themselves in a safe, nurturing environment by: Providing a venue for women to meet and explore their interests. Enhancing the individual wellbeing of women Providing programs to encourage personal growth Providing information to resource women Membership Details and Benefits The Membership year is from 1 July to 30 June. Individual Membership Fees: Business Membership Fees: $20 per year $40 per year $36 for 2 years $76 for 2 years (To receive room hire discount) Please select one of the following:*Individual Membership $20 per yearIndividual Membership $36 for 2 yearsBusiness Membership $40 per yearMembership Renewal $76 for 2 yearsName* First Last Address* Street Address Address Line 2 State Post Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact Number*Email* Payment Options*I will pay my $20 Membership Fee through PayPalI will pay my $20 Membership Fee direct to Womenspace Bank AccountPayment Options*I will pay my $36 Membership Fee through PayPalI will pay my $36 Membership Fee direct to Womenspace Bank AccountPayment Options*I will pay my $40 Membership Fee through PayPalI will pay my $40 Membership Fee direct to Womenspace Bank AccountPayment Options*I will pay my $76 Membership Fee through PayPalI will pay my $76 Membership Fee direct to Womenspace Bank AccountWomen's Space Bank Account Details Bank: ComBank BSB: 064 124 Account No: 1050 6275 Account Name: Women’s Space Association Inc. Reference: name and ‘membership’ How did you hear about Womenspace? Word of mouth Website Facebook Other OtherTotal Membership Fee $ 0.00 Authority to add your email to the newsletter list I agree to have my email address added to the newsletter list. Follow Us On Facebook
