Club Membership Registration Form

Membership Application & Renewal Form

Please do not use this form is you are unable to pay using online banking or PayPal. Apply directly at the club instead. Membership fee is $25
Application Date

DayMonthYear
Date
Membership type
Member Number
For renewals only
Name

First NameLast Name
E-mail
News Letter
Phone No.:

Area Code or 04Phone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date:

MonthDayYear
How did you hear about us?
Membership Agreement
MEMBERSHIP RULES
1. 1. Membership is available to anyone 18 years of age or older (subject to approval).
1. 2. You promise NOT to use to conduct any fraudulent or business activity or have more than one Member Account at any time.
2. 3. Membership fees stand at $25 and valid until the next AGM
  
  Access to the club is a privilege to be cherished and safeguarded.
  Where possible, members may be entitled to bar and event entry discounts.
After submitting your application you will be redirected to our PayPal payment page to process your payment.. Please manually enter 25.00

If you are unable to use PayPal, you can Direct Debit to our account.
TML's bank details are:
Bendigo BSB 633 000
a/c no.145134 490
Use reference: Your Name

Thank you for supporting the Tablelands Music Lovers! 🤗
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Membership Application & Renewal Form