Renew Your Membership

Title
your name
your last name

Membership is $40 p/a per household

I would like to renew for *

If you wish to make a donation also complete the section below.

I would like this donation used: (ensure amounts entered in each area add to the total donation above)

If you wish to make a Purchase also complete the section below.

Payment Options - to be completed via shop after submission.

Please deposit funds into the following account (either via your online banking or in person at a branch):

Account Name: Charcot-Marie-Tooth Association Australia Inc.

BSB: 032-069

Account No. 158486

* Please use your Last name as the transaction description.

Please make cheques/ money orders payable to

Charcot-Marie-Tooth Association Australia Inc.

Cheques/Money Orders can be post to the following address

PO Box 493 Engadine NSW 2233

* Please write name and detail of payment (Membership, Donation and area to be assigned on the back)

Credit Card payments are processed securely online by PayPal. Please click submit below to send details of your renewal to the National Office.

To pay by credit card via our PayPal facility, - proceed to membership page, select level of Membership, and proceed to check out. Complete your details and proceed to the payment page. Select the Pay with PayPal/Credit Card option, then the proceed to PayPal button. On this Page select the Pay by credit/debit card option and follow the prompts. Ensure the submit payment button is clicked for payment to be processed.

To pay by PayPal - follow steps above, on the screen after clicking Proceed to Paypal on payment Options, - Fill in email and password to login to your PayPal account, then follow promps, again ensuring the complete payment button is clicked for payment to process

A Receipt will be issued oce payment is processed

Bequests

Your annual membership fee and donations go to the cost of publishing our Newsletter, maintaining our website, posting out the information to people (whether they are members or not), verbal advice over the phone or face to face in the office and giving any assistance we can. We also hold seminars and pay the expenses of medical professionals to give talks at interstate seminars. In addition to this we also assist give financial support to research. We would like you to think about a bequest to the Association. This would ensure that our work can continue well into the future serving members and fellow sufferers of CMT. OUR AIM IS TO ENHANCE THE QUALITY OF LIFE FOR PEOPLE WITH CMT.