Renewal – Service, Affiliate & Social Members

Renewal Type(Required)

Service Member
Affiliate Member
Social Member

Boronia RSL Membership

Price:

Your Details

Name(Required)

Title First Middle Last

Post Nominals

Preferred name

Contact Details

Postal Address (If Changed)

Street Address Address Line 2 City State / Province / Region Postcode Country

Residential Address(Required)

Leave blank if residential address is same as above

Street Address Address Line 2 City State / Province / Region Postcode Country

Email(Required)

For sending renewal receipt

Mobile Phone

Preferred Contact Method(Required)

Mail
Phone
Email

I wish to receive promotional materials regarding electronic gaming machines and related activities(Required)

Yes
No

I wish to receive promotional materials and membership offers not related to electronic gaming machines(Required)

Yes
No

Privacy Statement

We will not use any of the information on this membership form without your specific permission in writing, other than to record you as a member or communicate with you as a member of the League.We will not passthis information to anyone outside the League without your express permission.

Pay for your membership renewal(Required)

You may use credit or debit card

Renewal – Service, Affiliate & Social Members

Your Details

Contact Details

Privacy Statement

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