MALA REQUEST TO BE ADDED TO A MAILING LIST
You can use the TAB button or the mouse to go to the next question..
please remember to press the 'SUBMIT' button
at the bottom of the page.
The privacy of your personal information is respected by MALA (Inc.)
Sign in to Google
to save your progress.
* Indicates required question
Which Mailing list do you wish to join?
Note that Rockingham Branch of MALA has now been wound up, but residents are invited to participate at Peel or Perth
PEEL (Mandurah & district)
POSTAL or STREET ADDRESS
SUBURB & POSTCODE
Mobile or landline - so we can contact you urgently in case of course changes or cancellations.
HEAR ABOUT MALA?
Word of mouth
I picked up a flyer
Saw it on a notice-board
Other (please tell us in comment below)
Send me a copy of my responses.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service