Membership Application Form 2025/26

UOVLG Membership 2025/26

ABN 15103149121.
Type
Category of Membership
Name

First NameLast Name
Email
Phone Number
Names of other family members that are part of this application:
Projects of interest

Other
Membership Fee
Individual ($20) Family ($30)
Donation
Please consider donating towards the cost of activities and projects
Total
Fee + Donation
Method of payment
Total for processing fee calc
Card processing fee
Total including card processing fee

Payment amount

AUD

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Please verify that you are human
Address

Street Address

Street Address Line 2

CityState

Postcode
Should be Empty: