ASA Change of Address Form

Please complete the Personal Information, plus anything that has changed.
Please also complete Just Checking at the end to help prevent errors.
Finally, make sure you hit the Send button at the bottom.
Thanks.


1. Personal Information

Title
Given Names
Family Name
Preferred Name


2. Address

(Work address preferred)

Organisation
Phone Number
Department
Fax Number
Street
Email Address
Town/Suburb
State/County/Province
Post Code
Country


3. Grade of Membership

(Select one)

Fellow Member Student Associate Associate Society


4. Comments

Is there any extra information you would like to add or comments to make?


5. Just Checking

As a security measure and to help prevent errors, please supply your current/old Organisation and Phone Number.

Organisation
Phone Number


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For information on all aspects of Astronomy in Australia visit the ASA's Australian Astronomy web site, featuring extensive links to astronomical research and teaching, public education facilities, amateur astronomy and other astronomical activities in Australia.