PLFC Membership Application

1. APPLICANT DETAILS

Name: *
Surname: *
Gender *
Male Female
Address *Your membership pack will be sent to this address.
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone
Email *
Date Of Birth *Eg. (30/12/1985)

2. MEMBERSHIP CATEGORY

PLFC Adult Membership *Pay securely with PayPal
Gold Package: $150 Season Pass Membership: $60
Student / Pensioner / Concession MembershipCan only be purchased directly from the club.
Applicant DeclarationBy proceeding with this membership purchase, you agree to be bound and will abide by the club’s Constitution and all of the relevant FFV Codes of Conduct/Behaviour and Conditions of Entry (available from www.plfc.com.au) at all venues for matches involving the Preston Lions Football Club.

Verification

Please enter any two digits with no spaces (Example: 12) *
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