Bathurst RSL Club Membership Renewal

Bathurst RSL Club Membership Renewal
Membership Number*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Territory

Postal Code
Email Address*
Phone Number*
Save a tree & go digital! I wish to receive my Renewal Notice & Notice of AGM electronically.*

YesNo
Occupation*
Preferred Venue for Membership Card

Bathurst RSL ClubPortland RSL Club

Membership Options

1 Year Ordinary Associate$11.00AUD

3 Year Ordinary Associate$22.00AUD

1 Year Pensioner/Senior$6.00AUD

3 Year Pensioner/Senior$12.00AUD

Total $0.00AUD

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country