Membership Application

Adult 1

Title: —Please choose an option—MrMrsMsMissDrProf.Rev.

Given Name(s):

Family Name:

Email Address:

Street Address:

City:

State:

Postcode:

Home Phone:

Mobile Phone:

Adult 2

Title: —Please choose an option—MrMrsMsMissDrProf.Rev.

Given Name(s):

Family Name:

Email Address (optional):

Mobile Phone:

No. Children: None123

Child 1

Given Name(s):

Family Name:

Date of Birth:

Email Address (optional):

Child 2

Given Name(s):

Family Name:

Date of Birth:

Email Address (optional):

Child 3

Given Name(s):

Family Name:

Date of Birth:

Email Address (optional):

Are you interested in playing with the BRO?
YesNo

Instrument(s) played:


Qualifications:


Previous Experience:

Are you interested in supporting BRO in one of these roles? Tick all that apply.
Management / AdministrationPlayer SupportFundraisingMarketing / PromotionSponsorshipIT / Desktop Publishing

Are any people in your membership interested in playing with the BRO?
Please advise person, instrument(s) played, qualification(s) and previous experience.

Are any people in your membership interested in supporting the BRO as a volunteer?
Roles include Management / Administration, Player Support, Fundraising, Marketing / Promotion, Sponsorship, and IT / Desktop Publishing.