Membership renewal email template

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Copy the text below into a new email, complete it and send it to info@esperanto.org.au with the subject line “AEA membership renewal”.

Hello,

I am renewing my membership of the Australian Esperanto Association. 
Below are my details.

1. First name: ___________________

2. Family name: ___________________

3. Address IF CHANGED (inc. postcode): ______________________________________

4. Telephone number(s) IF CHANGED (inc. area code): ___________________

5. Email address IF CHANGED: ___________________

6. Type of membership:
(Delete the lines that don't apply)
  - Ordinary full member $40.00
  - Full member – concession $30.00
  - Lifetime member $600.00
  - Lifetime member – age concession over 65 years $300.00
    (My date of birth: __/__/____)
  - Overseas member $30.00
  - Associate member $20.00
  - Family member or Youth member (to 21 yrs) $20.00
  - Organisational member $40.00

7. I will pay / have paid by:
(Delete the lines that don't apply)
  - Credit card via PayPal
  - Direct Deposit: Date: __/__/__; Description: _______________
  - Cheque or Money Order

Regards,