Membership Application Form

First name

Surname

Phone

Postal Address

Country/Region

Address

City

Zip / Postal code

Northern Territory Police Members

If you are a current member, your Registered Number

If you are a past member, your Registered Number

Please tick if you are a community or non-police member

Payment

Membership is $30 a year, starting July 1st each year. You may pay up to five years in advance. All membership payments are by direct payment* to the following account:

Northern Territory Police Museum and Historical Society

Nightcliff Community Bank (Bendigo Bank)

BSB 633 000

Acc 203 137 807

Please ensure you include your name with the payment, plus registered number if applicable.

By submitting this document, I acknowledge and agree to the rules, policies and procedures set out in the Constitution of the Northern Territory Police Museum and Historical Society Incorporated

Download PDF Form

As an alternative, download the PDF version to fill in and email, or print and post.

Download PDF Membership Form

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