Complete this form and deposit your payment to:
Account name: Canberra Queanbeyan Poultry Club
BSB: 805 022
Account No: 03388931
Please use your full name as the reference.
Fields marked with * must be completed.
I used to have poultry
Select all the boxes that apply to you.
Thank you. Click SUBMIT to send your application. Please remember to add your name as a reference
when you deposit your payment so we can verify your membership.