Puffing Billy Toy Library
New Member Application Form
Primary Contact
First Name:
Surname:
Mobile:
Email:
Member Type:
The Puffing Billy : $ 50.0
Stopping All Stations : $ 80.0
Full Steam Ahead : $ 150.0
All Aboard - NFP groups : $ 160.0
Limited Express : $ 20.0
Child Name:
Gender
M
F
Date of Birth:
Child Name:
Gender
M
F
Date of Birth:
Child Name:
Gender
M
F
Date of Birth:
Address:
Suburb:
Belgrave
Clematis
Cockatoo
Emerald
Gembrook
Monbulk
Selby
Tecoma
Other or not listed
Pcode
State:
ID Card and number: (Drivers Licence Number, medicare card):
First Roster Pref:
Any
Second Roster Pref:
Any
How did you find us?:
Event
Facebook/internet
Friend
Library
Member
Neighbour
Newspaper
Other
Playgroup
Previous Member
How can you help? (select more than one)
Toy Purchasing and Processing
Fundraising and Events
Marketing and Communications
Distributing posters to community businesses
Administration and Finance
Website and IT Support
I want to help but I`m not sure how! Please contact me
Clear
Conditions of membership
By clicking yes I agree to the conditions of Membership:
WAIVER, RELEASE AND INDEMNITY FOR BICYCLES AND SCOOTERS
By clicking Yes I agree to the Helmet waiver, release and Indemnity for Bicycles and scooters.