Personal DetailsMembership No.* Printed at the top of your renewal form.Name* Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Phone*Email Address Address Line 1 Address Line 2 Suburb State Postcode MembershipBefore renewing, the Arthritis NSW Board is offering members the option to change to a new affiliate status. Affiliate status is free for 2 years and as an affiliate you will receive the same benefits as a member, ie Arthritis Matters magazine and the opportunity to join one of our support groups. The only difference is that you will no longer have any Governance functions like attending and voting at AGMs. We hope this new option will be attractive to many of our members. Membership Type:* Affiliate Free for 2 years (AFFILIATE) Adult $49.50 for 1 year(MB_R_WEB) Adult Concession / Student $27.50 for 1 year(MB_R_WEB) Family $60.50 for 1 year(MB_R_WEB) Family Concession $44.00 for 1 year(MB_R_WEB) Please provide your Concession or Student number here:* Family Members to be covered by ANSW Membership*TitleFirst nameLast nameEmail Add RemoveDonationsAs my membership is free, I would like to make a donation in the amount of: Please enter the amount in dollars (eg. 10)I would also like to make a donation in the amount of: Please enter the amount in dollars (eg. 10)Payment DetailsTotal Credit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Security Code Cardholder Name CAPTCHAANSW Support Groups I agree to that my details may be provided to Arthritis NSW Support Groups in my areaLike-minded organisations Occasionally, we may allow like-minded organisations to contact you with information that may be of interest. They may allow us to do the same so we can reach more people with vital information. Please tick here if you do NOT want to receive communications from organisations we trust.NameThis field is for validation purposes and should be left unchanged.