Thorntree conservancy Po Box 1552 Walkerville 1876 Registered Conservancy GCA037

Application for Membership

I, ________________________________________________ Owner/tenant

 of Plot ____________________________________________ Walkers Fruit Farms, would like to include my property in /be a member of Thorntree Conservancy, and agree to pay the annual membership fee of R300.00 per annum or R25 per month.  Payment of membership fees will entitle me to certain rights and benefits as a Conservancy member. The membership fee includes membership of the Midvaal Fire Protection Association

Postal Address : ____________________________________________________

_________________________________________________________________

__________________________________ 

Code : _________

E-mail Address_____________________________

Telephone No : (Home) : _________________________

                     (Work)____________________________ 

SIGNATURE_______________________________

Date_____________________________________

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