Office Address*

Headshot - Profile Picture 

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Questions, Comments, Queries, Special Requests.

If you want us to know something special, here's your chance. Don't disappoint!

How did you hear about us?

If it was a friend, tell us their name in the Other box.

Acknowledgement of Costs*

I agree to make a payment of $400 once per year to be distributed quarterly to the charities selected through the voting process by the members. I also agree to pay $100 +GST as an initial setup fee. This is a one time cost.

I agree to the following costs:

1. One-time set up fee of $100 + GST (invoice will be sent from KiltedMedia)
2. $400 per year to be distributed quarterly to the charities selected through the voting process by the members.  This can be paid annually or quarterly through the online payment portal you will be directed to once you submit this form.

Both costs must be received before membership is activated.