New Group Membership Application Form

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The insurance broker needs a breakdown of the ages of the members in your group. Please advise details below.

How many of your members are aged :

Payment for New Group Membership is $85. This includes a $60 Annual Fee and a $25 joining fee. Please send payment of $85 using one of the options below.

The Annual Fee for a Group Membership with 1 - 25 members is $180, which includes a base annual fee of  $60 and a joining fee of $25.

The Annual Fee for a Group Membership with 26 - 50 members is $225, which includes a base annual fee of  $60 and a joining fee of $25.

The Annual Fee for a Group Membership with 51 - 100 members is $335, which includes a base annual fee of $60 and a joining fee of $25.

The Annual Fee for a Group Membership with 101 - 200 members is $465, which includes a base annual fee of $60 and a joining fee of $25.

The Annnual Fee for a Group Membership with 201 - 300 members is $515, which includes a base annual fee of $60 and a joining fee of $25.

The Annual Fee for a Group Membership with 301 - 400 members is $595, which includes a base annual fee of $60 and a joining fee of $25.

The Annual Fee for a Group Membership with 401 + members is $645, which includes a base annual fee of $60 and a joining fee of $25.

Please send cheque made payable to Victorian Quilters Inc. to:
Victorian Quilters Inc.
c/- 5 Robinson Rd,
Kooroocheang VIC 3364
with your Group name in a letter, or a copy of the pdf you will receive after submitting this form.

Please deposit to :
Victorian Quilters Inc.
BSB 033 180
A/C 302487
For the Reference, please use Your Group Name

Please notify Victorian Quilters Inc. of any changes to the above details using the Contact form on the website.