Renew your membership

Name*

First Last

Email*

Phone number*

Mailing address*

Primary Residential Address*

Birthday month*

Occupation*

I wish to pay my $50 membership fee...*

via Direct Debit
at the bar next time I visit

If you elected "Direct Debit" PLEASE WRITE THESE ACCOUNT DETAILS DOWN.

Please use your surname in the narrative so we can identify your payment.

The bank details are:

Cowaramup District Social Club
Bankwest
BSB 306-021, Account: 4631370

Your membership will be confirmed upon receipt of your payment. Thank you for your interest in this 65-year-old institution, that was established by the local community, for the local community. We are volunteer-driven, with the committee volunteering several hours per month to ensure the Club stays vibrant, responsive to member needs, and (importantly!), profitable to ensure a sustainable future. If you would like to volunteer in any capacity, please let’s know what you can do to help:

Name

This field is for validation purposes and should be left unchanged.

About

Membership Renewals Form

Anita Revel