Misty Dinner Dance
Member Details
Title :
MrMrsMsMiss
Other :
First Name
Last Name
Phone Number
Email Address
Address
Post Code
Family Member Details
Spouse / Partner
Children
Student Membership Details
School or University
Membership Type :
New MembershipRenewal of Membership
Introduced By
Proposed by Commitee Member
Membership Subscription Types :
Pensioner—Single $10Single $15Student—Single $10Pensioner—Family $15Family $25
Download the WASLA Constitution here.
By submitting the form below I confirm that I wish to become a member of the West Australian—Sri Lanka (Ceylon) Association, Inc. and agree to abide by its constitution and by laws.
Payments for Subscription
Cash or EFT accepted
Account Number - 518950
Payee Details : BSB - 036062
Payment Reference : SUBS Surname Initials
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