Dr
  Mr
  Mrs
  Miss
  Ms
  Other Title

  Given Name

  Surname

  Organisation

  Mailing Address
(PO Box or Street No and Name)

  City/Suburb

  State

  Postcode

  Country

  Your E-Mail Address

  Contact Phone
(include country & area codes)

  Contact Fax
(include country & area codes)

Comments:

Your membership can also be registered by printing out this form and mailing or faxing to:

Australian GPS Society
PO Box 1380
Palm Beach, Queensland 4221
AUSTRALIA
Phone: +61 7 55 204 288
Fax: +61 7 55 082 175