2024 Xmas Membership Form - Draft

1Select a Membership

2Member Details

3Confirm & Pay

Please note: this form is only for purchasing a National Trust of Australia (Victoria) gift membership. If you would like to join another state or if you would like to membership for yourself please visit www.nationaltrust.org.au/join
Your State/Territory(Required)
This field is hidden when viewing the form
I would like to
- Purchase a gift membership for someone
Who should we send the membership pack to?(Required)
- To me (the gift giver)
- To the Gift Recipient
Duration
Membership Category(Required)
- Household
Family
Covers 2 adults and children under the age of 18. (Grandparents can substitute grandchildren for children).
Membership Price
$ 0.00
Gift giver details
These details are for the gift-giver. The gift recipient (member) details can be entered during the next step.
Name(Required)
First Last
Email(Required)
Phone(Required)
Address(Required)
Street Address City State / Province / Region ZIP / Postal Code Country

Your Order Details
Your gift membership application is almost complete. Please review your order and enter your payment details below.
We'll send the gift membership pack to {Postal:55.1}, {Postal:55.3} {Postal:55.4} {Postal:55.5}.
We'll send the gift membership pack to {Postal:99.1}, {Postal:99.3} {Postal:99.4} {Postal:99.5}.
Your gift Membership
Membership Type:
{Membership Category:16}
Recipient Name:
{Your Name:30.3} {Your Name:30.6}
Recipient Email:
{Your Email Address:35}
Recipient: Phone:
{Daytime Phone:33}
Recipient Address:
{Postal:55.1},
{Postal:55.3} {Postal:55.4} {Postal:55.5}
Product Price
Membership
$ {Membership Category:16:price}
Donation
Total {subtotal}
Billing Address(Required)
Same as Postal Address
Street Address City State / Province / Region ZIP / Postal Code Country
Credit Card(Required)
American Express
MasterCard
Visa
Supported Credit Cards: American Express, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Terms & Conditions NSW(Required)
- I have read and accept the Membership Terms & Conditions

2024 Xmas Membership Form – Draft