Renewal/Subscription Form - Point Lonsdale Civic Association Inc. 
PO Box 28 Point Lonsdale VIC 3225 Reg. No. A0017883S

Email: plcasecretary@gmail.com Website: www.plca.org.au

Representing Point Lonsdale Residents since 1910

Thank-you for your kind support!

Sign in to Google to save your progress. Learn more
Today's date: *
MM
/
DD
/
YYYY
Name: *
Email address *
Payment Method: 
$10 subscription per person per year
*
(PLCA - Bank Account details) 

BSB: 633 108

A/C Number: 1313 46017

Description: Surname, Initials

Optional - Please fill in this section if you would like to make a donation only. Please indicate below the amount you'd like to donate.
Optional - What Issues in 3225 would you like to see the Association tackle?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy