Join MS Otago 2021 – Offline Payment Name * First Last Additional Family members or Organisation name Email Address * Choose your membership type: Individual Annual Membership - $30.00 Family Annual Membership (up to 4 people) - $50.00 Corporate Annual Membership - $100.00 Your membership will be valid from 1 January 2021 to 31 December 2021. Additional donation $ Any donation helps us deliver our service. Total $ 0 This is the total amount to pay after submitting the form. You can pay in two ways: 1. By bank transfer to 06-0911-0922057-00 using your surname as the reference. 2. By cheque made out to Otago Multiple Sclerosis Society delivered to MS Otago Dunedin Community House 283 Moray Place Dunedin 9016 Please include your name with the payment.