The new MCA logo, a blue 'M' with embedded 'C' and trailing 'A'

 

 

 

 

 Membership / Subscription Form 


Please post to:
Medical Consumers Association Inc., P. O. Box 230 Balgowlah,     NSW 2093     AUSTRALIA


Please tick only one of the 4 following options:

For address within Australia : I enclose payment for 2003 membership / newsletter subscription.

A$15 .................

or

 

For address within Australia : I enclose payment for membership /newsletter subscription for 2003 and for a members' copy of the MCA 2003 archive CD          

A$35 .................

or

 

For address outside Australia I enclose payment for international postage * membership / newsletter subscription for 2003

A$22 .................

or

 

For address outside Australia I enclose payment for international postage  * membership / newsletter subscription for 2003  and for a members' copy of the MCA 2003 archive CD

A$44 .................

 (* this rate includes air mail postage of the MCA newsletter and CD, payment must be in Australian Dollars)

Method of Payment:
Within Australia - Personnel Cheque, Money Order or Bank Draft
International - Bank Draft drawn on any Australian Bank.
Payments to be made out to Medical Consumers Association.


Name : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Please give title (i.e. Ms Mr Dr etc):

 Full Postal Address :

 

 

 

(Four editions of the MCA newsletter will be sent to you at this address over the next year. The CD, if ordered, will be sent with your first newsletter. (The 2003 edition of the MCA CD contains past MCA newsletters reports etc. up to December 2002). Newsletters are published 4 times a year and the most current issue at the time of your application will be sent as the first of the 4 issues your annual subscription covers)


Any additional information/comments you wish to provide:
(E-mail / Telephone / FAX etc . Profession , interests , skills , qualifications, experiences and views about medical services etc.,)