Association of French Teachers in Victoria Inc
A00022528R ABN 50 793 754 960www.aftv.vic.edu.au /
TAX INVOICE
Membership subscription form 2012
Title: Mr / Mrs / Miss / Ms / Dr (Delete non-relevant options)Surname: ......
Given name: ......
School or Private address (Please indicate. Any postal correspondence will be sent here)
...... Postcode ......
Phone number I can easily be contacted on: ……………………………………………………..
Email address: ______
Print clearly as confirmation of your subscription & most other correspondence will be sent here
School / Institution name: ......
Please circle the relevant option or delete non-relevant options for the following:
Ø This is a primary / a secondary / a tertiary / another sort of school / no school
Ø This is a Government / a Catholic / an Independent / another sort of school/ no school
The AFTV Carrefours magazine will be circulated as a pdf via email in 2012. Please place a tick if you would also like to receive a hard copy. ☐
Name & phone number of school’s accounts payable contact :
………………………………………………………………………………………………………………..
Full Personal Membership rate $70 GST free
**Early bird rate until 31/12/11 $60 GST free
Concession Personal Membership Rate $40 GST free
(Only students/people not in continual employment during 2012 are eligible for concession rate)
All membership fees are tax-deductible. See payment options overleaf.
Only the individual nominated on the AFTV membership form will receive member benefits.
Individual membership not transferable
I have paid $...... via EFT and have sent my EFT receipt to the AFTV (no AFTV receipts will be issued)
I have paid $...... via personal cheque. Please place a tick if you would like a receipt . ☐
I have paid $...... via school cheque for ……. member/s. Please place a tick if you would like a receipt . ☐
This form will constitute a TAX INVOICE upon receipt of payment. Please keep a photocopy for your records.
Preferably email this page to Tasha at
Or post to Tasha Brown-Paquier, AFTV Bookings and Membership Officer, 56 Home Rd, Newport, 3015
Phone: 9399 5400
J Preferred payment method: Electronic Funds Transfer:
PLEASE QUOTE REFERENCE CODE: MEM2012 and include your surname
Account Name: Association of French Teachers in Victoria Inc.
BSB: 704 191 Account Number: 196251
Bank: Victorian Teachers Credit Union
ABN 50 793 754 960 AFTV Inc A00022528R
Please send your EFT receipt to or Tasha Brown-Paquier, AFTV Bookings and Membership Officer, 56 Home Rd, Newport, 3105
Payment by cheque
Please make cheques payable to AFTV Inc (no subscription agency cheques, please) and send to Tasha Brown-Paquier, AFTV Bookings and Membership Officer, 56 Home Rd, Newport, 3105
Please contact us if you have not received confirmation of your subscription within two weeks.