Melbourne Gliding Club

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Donation

* Mandatory fields
 

Member details

*First name
Please enter your first name.
*Last name
Please enter your surname.
*Date of Birth
Used for identification confirmation, awards, qualifications, certifications etc. use dd/mm/yyyy format.
*Age group
This information is used instead of date of birth for all club reporting. (added for 2017)
*Phone - Mobile
Primary contact number for the club e.g. 0412123456
*Phone - Home
Alternative contact number E.g. 03 86837240
*e-Mail (primary)
Used for Membership system, Accounts & Newsletter etc.
*e-Mail (secondary)
Alternate email address
 

Postal address

*Address
Used for correspondence e.g. Po Box 767 or 757 Boeing St
*Suburb / City
Example: Melbourne, Toorak
*Post Code
Example: 3001
Country
Use if living outside Australia.
 

Physical address

*Street address
Example: 57 Nimbus st, Bacchus Marsh, Vic, 3340.
*Suburb / Town
e.g. Toorak, Bacchus Marsh, Private. Field is published for members to facilitate car pooling etc.
 

EC - Emergency contact details

*EC - Name(s)
Emergency contact name(s), enter multiple names if applicable
*EC - Phone (mobile)
Emergency contact mobile number, enter multiple numbers as applicable
*Amount ($AUD)
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