Abstraction Workshop
Seeing Differently
with Dinusha Joseph

Please complete the following form including your full name as a payment reference for electronic funds transfer (EFT) or cheque.

$200 for HAS members or $230 for non-members.

Name

First Name

Last Name

Email Address

Contact Phone number

Address ( so we can send you a yearly Membership card )

Payment Method

Electronic Transfer

Cheque

If account name on payment is different to member's name, please specify

BSB : 063 138

Account Number : 0090 1737

Account Name : Hawthorn Artist Society Inc.

Reference : Include your name including surname

Post to : HAS Secretary, PO Box 37, Hawthorn 3122

Reference : Please include your membership number and full name written on the cheque or on an accompanying form.

ABN: 41 006 086 273
Reg. No. A0027862V
We respect your privacy and will not pass on you details to third parties.