VJMC Australia Web Portal - Membership Form

VJMC Membership Application

This online form requires that you use a current or supported version of your web browser. Not doing so could result in errors and/or failure to submit.

Salutation *

First Name *

Last Name *

Address: No. and Street *

Suburb *

State *

Postcode *

Home Num. - Landline or Mob. *

Work Phone Number

Mobile Phone Number

Email Address *

Confirm Email Address *

Have you previously been a VJMC member?

Yes

Previous Member Number or Year

The VJMC publishes a regular club magazine. The magazine is available to members either by printed copy posted to you, or by email. Please indicate your preference:

VJMC Magazine preference: *

Membership Type *

Number of Years to Pay *

Plus one off joining fee.
$5.00

Total Membership due.

Name of other family member/s (must live at the same address)

Preferred First Name/s for Name Badge/s (if any)

Payment

Membership will not be processed until your subscription funds have cleared. Please note: Australia Post can now take 7-10 days to and from remote areas. The below payment details will be sent to you by email once you submit this form.

Cheque or Money Order

Please make cheques or money orders payable to the "VJMC Inc" and send to:
Membership Secretary
VJMC Inc
PO Box 254,
Modbury North, SA. 5092.

Direct Deposit.

Commonwealth Bank
BSB: 062 801
Acc: 1024 0688
Reference: NEW MEMBER, Your surname.

If you do not receive an email confirming your application within 30 minutes of submitting this form, please i) check your Spam/Junk folder and ii) if required, send an email to Membership@vjmc.org.au.

If you click the Submit button below and it doesn't take you to a green confirmation screen, you may have missed filling in one or more mandatory items (marked with a red asterisk). You must also click the "I'm not a robot" checkbox above this note.

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