Membership Application

Step 1: Application

New Members please enter your details below.

    Full Name

    Email

    Residential Address

    Mailing Address
    (if different from residential address)

    Contact Number

    Please select membership type

    Are you joining as part of our Gippsland Outreach Program?

    YesNo

    How would you like to pay for your membership?

    Via PayPal (Step 2 below)In person at the library (cash, cheque and EFTPOS available)Over the phone (credit card)

    For Paypal payments only. If you are making payment on behalf of someone or making payment from an account with a name different to yours, please tell us the name of the account so that we can match your application with your payment.

    You are also not required to create a Paypal account to pay via this method.

    How did you hear about PMI Victorian History Library? (Optional)

    Please use the field below for any comments or further details. (Optional)

    By clicking 'Apply' you confirm that you agree to our Membership Terms & Conditions. If you are making payment via PayPal, please proceed to Step 2 once you have submitted your information to make payment and complete your application.

    Step 2: Payment

    If you are paying online, please continue below. You do not need to have a PayPal account to pay online.

    Membership Type