APS Keilor Plains Group - Membership Form
Please complete form below if you wish to JOIN or RENEW your membership. Then, below this form are details on how to make your payment.
If family membership give all names; e.g. Bob, Sue, Jasmine, Toby
PO Box or unit, house number and road/street.
Postal delivery of The Keilor Plains Group Newsletter
The Keilor Plains Group Newsletter will be delivered to the e-mail address you have supplied. For postal delivery, select "Yes"
Are you renewing your membership or joining for the first time?
(By answering this question you are agreeing to be bound by APS Victoria and the Keilor Plains District Group Rules and Bylaws)
Please indicate the membership category you desire.
(Each category includes the Keilor Plains District Group Fee of $10)
Single - $42
Household - $45
Student - $34
Organisation - $50
Please indicate how many years you'd like to join for.
(NB. the amount payable will be the annual fee x number of years; e.g. Household membership x 3 years = $135)
If "EFT" or "Pay at a Bank Branch" is chosen below, please note that banks details are at the bottom of this form, and include as reference "family name/MEMBER"
Pay Cash at a meeting
Pay at a Bank Branch
Emergency Contact Person
Please give the name and telephone number of a person we should in an emergency.
Emergency Contact Phone Number (Home)
Emergency Contact Phone Number (Mobile)
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