Become a Member of ADEC

Please complete all the fields in this form click on the print button on your browser and post it to the address below with your cheque or money order. Please do not send cash.

For a schedule of charges see Fees and Charges

Please accept my membership to "Action on Disability within Ethnic Communities Inc"

Name of Applicant
Name of Organisation
Address
Suburb
State
Post Code
Phone
Fax
E-mail
Enclosed is:
	Cheque or Money Order only please


I would prefer information in the following languages:

Please mail the printed form to:
ADEC,
175 Plenty Road, Preston, VIC, 3058,
Australia

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