Victorian Pinto Society Inc – Membership

Title, Names

Title:

First Name:*

Surname:*

Gender:

Date Of Birth:

GST Registered:

ABN:

Property IdentificationCode:

Occupation:

School:

Junior members only

I want to receive newsletters electronically.

Contact Information

Business Hours:

After Hours:

Work Fax:

Home Fax:

Mobile:*

Email:*

Preferred Correspondence Method

SMS

Residential Address

Line 1:*

Suburb/City:*

Postcode:*

Other Information

Disclosure

By completing this application for membership you will be supplying the Victorian Pinto Society Inc. with ‘personal information’ like your name, address & phone number

Without this information, we will not be able to administer your Membership in the Victorian Pinto Society Inc.

Please indicate below if you do not wish your personal information to be made available to persons contacting the Victorian Pinto Society Inc.

I do not wish my personal information to be available to persons contacting the Victorian Pinto Society Inc.: