Title

First Name*

Last Name*

Address Line 1*

Address Line 2

Suburb*

State*

Post Code *

Email*

Mobile Phone*

Home Phone

Membership Duration*

1 year $15
3 Years $30

Correspondence

I agree to receive communication via email

Terms and Conditions*

I hereby apply to become a member/renew my membership of the Lugarno Progress Association Incorporated
I agree to terms and conditions of the LPA constitution

Fees and donations to the Lugarno Progress Association can be paid by direct deposit.
Account name: Lugarno Progress Association
BSB: 062234
Account Number: 00800026
Please put an identification reference on the payment, e.g.Surname_Initials
OR
pay by cash at a monthly meeting.
If paying by EFT deposit, please enter the receipt number below.

EFT Receipt Number

Lugarno Progress Association

Member Registration