Membership Application Form


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Clan Mackintosh Society Australia Inc.

Application for Membership

  
   
    Full Name:  
    Address:  
     
    State: Postcode: Telephone (incl. area code):  
    Email address:  
   
 

 Relationship to Clan:









  State your Mackintosh or Sept connection; If possible, briefly trace family
   history to Scotland; A completed Pedigree Chart would be appreciated,
  but NOT compulsory.

  
   
    Signature: Date:  
     
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Subscriptions are $A15 per annum within Australia
(Email us for quote for overseas membership)
Please make cheques payable to: Clan Mackintosh Society Australia

Post your completed form with the subscription to:
Clan Mackintosh Society Australia Inc.
P.O. Box 2054
CAULFIELD JUNCTION VIC 3161
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