PEPE Inc. Renewal of  Membership Application Form

Membership fees of $100.00 are now due for the period 1 January to 31 December 2001.

Annual membership fees entitle you to access to the Members section of the Association web page, Research Monographs, two electronic newsletters per year and two electronic PEPE Journals per year.

Please complete the following Tax Invoice/Membership Application and forward it together with your cheque to

Treasurer
PEPE Inc.
Professional Experience Unit
Faculty of Education
Queensland University of Technology
Victoria Park Road
KELVIN GROVE Q 4059

TAX INVOICE

ABN: [to be supplied]

TO:

Membership PEPE Inc. 1/1/2001 - 31/12/2001 $100.00

NOTE: Membership Fees are GST inclusive

Cheques payable to: PEPE Inc.

Please complete in print script:

Mr/Mrs/Ms/Dr/Prof/Fr______________________________________________________

(Given Name) (Family Name)

Institution:_______________________________________________________________

Postal Address: __________________________________________________________

______________________________________ P/C:________________

Phone: (W)___________________________ (Mobile) ___________________________

(H)___________________________ (Fax) _____________________________

(Optional)

Email: _____________________________________________

Discipline (eg Law): ______________________________________________________

Area(s) of interest (eg internship) ____________________________________________

_______________________________________________________________________