50th Anniversary - Past Member Details

Past Members of the club are asked to completed the information below so that we can contact them about our 50th Anniversary Celebrations.

Name *

Street *

Suburb *

State *

Post Code *

Email *

Phone

Period of Membership

I am interested in attending the 40th Anniversary Dinner and/or other functions. (Please put the number of people interested in attending in the Comments box below)

Phone

Email Address

Period of Membership
I was a member during the following years (approximate start year and end year e.g. 1986/87 to 1993/94):

40th Anniversary Dinner

Information
I can help with the search for the following information:
Photos
Programs, Results, Newsletters etc.
Club Documents
Trophies
Uniforms & Memorabilia
Member Profile (see below)
Other:

Member Profile
Please provide some information about your time at the club:

Comments/Other Information