Membership Application Form
Period Ending 31 December 2017

Applicant Details

DECLARATION: I agree to be bound by the Constitution and By-Laws of the Association and I certify that the information provided hereon is true and correct.

Next Of Kin

If you would like to make a donation please fill in your selected amount below

By submitting this form I agree to make the annual payment of $30 for the annual subscription plus donation amount if applicable within 48 hours by direct deposit to VVPPAA's bank account at Holiday Coast Credit Union BSB 721 000 Account number 65796