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On-Line Membership Application Form
Welcome to the On-Line application form.
Please complete all fields marked with an *
Name
*
First name
Last name
Nick name
Landline phone
Persons address
*
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Cell phone
Email address
*
We would be grateful if you could consider the following opportunities to assist us.
Committee role
No
Yes
Audio and visual at meetings
No
Yes
Newsletter assistance
No
Yes
Publicity team
No
Yes
Short talks
No
Yes
Introduction and thanking speakers
No
Yes
Welcoming people at meetings
No
Yes
Subscription 2022
The subscription has been set at $20
Payment details:
U3A Beachside BOP Inc.
ASB 12 3217 0213297 00
Please put your Surname in the the "Reference" field
Please check the highlighted fields
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