Application for Renewal of Membership

Membership Renewal

Use this form to renew your Membership to the Ops Room Association Inc.
Your Name *

First Name Last Name
Partners Name

First Name Last Name

Home or Postal Address *

E-mail
Work E-mail
example@example.com
Preferred email *
We will contact you by this email address
Home Number

- Area Code Phone Number
Mobile Number *

- eg 0400 eg. 111111
If any of your contact details have changed, please advise our Secretary by email immediately, this helps us keep you informed of Association matters.
Ops Room Badge No *
eg. Membership No issued on joining the Association
Years for renewal Required *
eg. No of years you want to renew?
If Other selected above.
How many years do you want for renewal eg. 20 Years
Fees Deposited *
What you have deposited into our Bank Account. eg. $5.00 per year.
Comments
Enter here anything you think we may need to know?
Payable Direct Deposit to WESTPAC
Ops Room Association Inc.

BSB: 037-604. Account Number: 334430.

Please put Surname and Initials in the comments line on your Direct Deposit with the Bank.

A receipt of monies paid will be issued by email only. Once monies are received, a receipt number, will be emailed to you.

If any of your contact details change, please advise our Secretary by email immediately, this helps us keep you informed of Association matters.

Thank You!
Office Use Only:
Date Deposit Received
Receipt No Issued
Date emailed
Should be Empty:

Membership Renewal