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Fam. Concession – $45FULL Single Member – $50FULL Single Concessn -$40FULL Family Member -$70FULL Fam. Concessn -$60Other Active Family Members Name/sWe love to know about family members who will be involved.๐OtherAUDPost Natural History Journal *Printed + Posted $20 p.a. – Free digital copy is emailedYesNoThanks for your Optional Donation !Add your Donation amount – Minimum $2 to be tax deductibleRENEWAL TOTALShows what you will pay in Total once Payment Method is selected.$Payment Method *PayPal or Credit CardDirect DepositCheque PaymentDeposit Details *Make the Deposit and use your name as a reference for the transfer.Please add the Reference and Receipt number here so we can identify the donation.Cheque Details *Write the Cheque and then:Please enter your Bank Name and the Cheque Number here so we can identify the donation.Please post the cheque to the address listed above the form.Consent * Confirm that all information provided is accurate and consent to process the Payment. 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Wombats SA will send a receipt.ย Our Response for a PayPal Donation:Thanks {name-1}! ๐You will get an email from PayPal.Once we receive the PayPal Renewal Payment, we will let you know and send a Tax Deductible receipt.Plus 1 digital Natural History journal per Qtr, (+ Printed copies for $20.00) & Thanks for any Donations!๐งพPlease select PayPal Checkout or Debit or Credit Card below.Our Response for a Direct Deposit:Thanks {name-1}! ๐Please make sure the Deposit Details needed are correct above.Once we receive the Direct Deposit Renewal Payment, we will let you know and send a Tax Deductible receipt.Plus 1 digital Natural History journal per Qtr, (+ Printed copies for $20.00) & Thanks for any Donations!๐งพPlease Click the Donate button below to finish the process.Our Response for a Cheque Payment:Thanks {name-1}! ๐Please make sure the Cheque Details needed above are correct.Once we receive the Cheque Renewal Payment, we will let you know and send a Tax Deductible receipt.Plus 1 digital Natural History journal per Qtr, (+ Printed copies for $20.00) & Thanks for any Donations!๐งพ Please Click the Donate button below to finish the process.Make Payment