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Rhema 1065fm Membership Application
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Please check the required fields
Title
*
Mr.
Mrs.
Ms.
Mr&Mrs
Rev.
Pr.
Dr.
Prof.
Sir.
Lady.
Other
Required
Name
*
Required
Address
*
Required
Town/Postcode
*
Required
Phone
*
Required
Other Phone
Optional
Email Address
*
Required
Church Denomination
Optional
Membership/Supporter Type
*
Family(includes children under 18) - $66.00
Individuals - $66.00
Single Pensioner - $33.00
Student(full-time) - $33.00
Junior Member under 18 (non-voting) - $11.00
Church/Organisation/Business - $154.00
Life Subscriber - $1144.00
Daily Devotional(non-member)per year - $33.00
Daily Devotional additional sub(member)p/y-$16.00
Required
Payment Method
*
Cash over the counter at Rhema
Cheque over the counter at Rhema
Cheque by mail
Money Order over the counter at Rhema
Money Order by Mail
Credit Card by phone 07 5442 2833
Credit Card over the counter at Rhema
Credit Card by secure PayPal online at web site
PayPal online at web site
Required
Special Instructions/Comment
Add any special instructions regarding your application.(optional)
Security Code:
*
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