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APU_Membership Form
(SPOTTER & LOADER, VOLUNTEER & SUPPORTER Membership ONLY)
Australian Powerlifting Union LTD Version 2901.21-3
Form Created By: Sectio (Tyo Muir)
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Gender
*
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
Address
*
Your answer
Telephone
*
Your answer
Email
*
Your answer
Next of Kin Name
*
Your answer
Contact Details
*
Your answer
Relationships
*
Your answer
Are you an AU Citizen or AU Permanent Resident?
*
Yes
No
If no for previous question, please provide the details
*
Your answer
Club
*
Your answer
Coach
*
Your answer
Member of other powerlifting organisation
*
Your answer
Are you intending on coaching or becoming an official (IF Yes, please email your Working With Children Check to
memberships@powerlifting
.org.au)
*
Yes
No
Membership (include 10%GST)
*
NON LIFTER_Spotter and Loader (AUD 1.1), YEARLY Membership
NON LIFTER_Volunteer and Supporter (AUD 1.1), YEARLY Membership
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