Member - Registration - LCAS - Lane Cove Art Society

Application for Membership

* Email Address

* Confirm Email Address

* Password

Strength: Very Weak

* Confirm Password

* First Name

* Last Name

* Phone Number

Mobile Number

* Address

* Suburb

* Post Code

* Emergency Contact Name

* Emergency Contact Phone Number

Other interests (if any)

* Terms & Conditions

I hereby apply to become a member of the Lane Cove Art Society Inc. I will endeavour to be an active member, to support the Society to the best of my ability, to attend the General Meetings and other events.

Payment Option Must be via:

Bank Transfer

Bank Transfer:
Account Name: Lane Cove Art Society
BSB: 062 192
Account Number: 00901135
In description please enter “M’ship” and Surname

Lane Cove Art Society Member Application