Pay DEA membership/donation by cheque

Doctors for the Environment (Australia) Inc Subscriptions
Thank you for your decision to support DEA financially. Your subscription is very important to us.

Step 1

Fill in your details below:
Name:
Address:
Email:

Step 2

Pay my membership fee and/or pay donation of:
Ordinary membership of $42 plus donation of $

Step 3

Please print this form:
Click to print this page
If you do not have access to a printer, please write down your full name and contact details.

Step 4

Send this form/your details with a cheque made payable to "Doctors for the Environment, Australia" to:
Dr. John Stokes
Treasurer, DEA
6 Reginald Street
Cottesloe, WA 6011
Thankyou
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