Membership | Fiji Seniors SA

Membership Application Form

Any person who wishes to join the Association must be fifty-five years of age or older, must complete the form in full below and pay the required membership upon joining. Membership is valid from fist January to thirty first December in a calendar year.

Title *

First Name *

Last Name *

Subject *

Date of Birth *

Address *

Suburb *

Post Code *

Home Phone

Mobile

Your Email *

Acknowledgment *

I wish to apply/renew membership of Fiji Senior Citizens Association of South Australia Inc. I undertake to abide by the rules and regulations of the Fiji Senior Citizens Association of SA Inc.

Custom Text *

I give my consent

Custom Text *

I do not give my consent :

to the Club to take group or individual photograph of myself. The Club will keep the photos as record and also may load on Club's Website.

Date*

Submit

Please deposit membership application fee of AUD $25.00 to:

Account name: Fiji Senior Citizens SA

Bank name: bank SA

BSB: 105-131

Account number: 044502540