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Life Membership Nomination 2026

Sat 15 Aug 2026 09:00 - Fri 04 Sep 2026 17:00

Jubilee Park Hockey Complex, Red Hill Road Wagga Wagga

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First name*

Last name*

Phone number*

Email address*

Address*

Nominee Name (first and last)*

How many years active service to the organisastion?*

Supporting statement of life membership (please attach document)*

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Max 5MB

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*

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