Banyule Toy Library
New Member Application Form
Primary Contact
First Name:
Surname:
Mobile:
Email:
Second Borrower:
First Name:
Surname:
Mobile:
Email:
Member Type:
3 Months : $ 40.00
6 Months : $ 80.00
Standard : $ 150.00
Standard - Health Care Card/Seniors : $ 80.00
Volunteer : $ 75.00
Volunteer - Health Care Card/Seniors : $ 40.00
Language other than English:
Arabic
Bengali
Cantonese
Danish
Dutch
French
German
Greek
Gujarati
Hindi
Indonesian
Italian
Japanese
Mandarin
Marathi
Persian/Dari
Portuguese
Punjabi
Russian
Somali
Spanish
Thai
Urdu
Vietnamese
Other
Address:
Suburb:
Bellfield
Briar Hill
Bundoora
Diamond Creek
Eaglemont
Eltham
Eltham North
Epping
Greensborough
Heidelberg
Heidelberg Heights
Heidelberg West
Hurstbridge
Ivanhoe
Ivanhoe East
Kalkallo
Kingsbury
Lower Plenty
Macleod
Mernda
Mill Park
Montmorency
Plenty
Preston
Reservoir
Rosanna
South Morang
St Helena
Thomastown
Viewbank
Watsonia
Watsonia North
Yallambie
Other or not listed
Pcode
State:
ID Card and number: (Drivers Licence Number, medicare card):
How did you find us?:
Attending Interlaken Kinder
Book Library
Community Event
Competition
Council
Current or Previous member
Facebook
Internet search
Maternal Health Centre or New Parent Group
Other
Refer a Friend Promotion
Small Ideas Voucher
Toy Libraries Australia Website
How can you help? (select more than one)
Promotions
Fundraising
Grants
General Committee Member
Newsletter
Website Design
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Conditions of membership
By clicking yes I agree to the conditions of Membership:
WAIVER, RELEASE AND INDEMNITY FOR BICYCLES AND SCOOTERS
By clicking Yes I agree to the Helmet waiver, release and Indemnity for Bicycles and scooters.