Membership
New Members Welcome
The Kuljak Lacrosse Club of Western Australia was formed in 1963 and incorporated on the 13 day of March 2001. If you wish to become a member, fill out the form below, and send to the secretary with payment of your preferred form of membership (You can subscribe for 1 year or become a Lifetime Financial Member with or without club merchandise.)
KULJAK MEMBERSHIP APPLICATION (2010)
Surname ……………………………………………………………..
First name…………………………………………………………….
Address………………………………………………………………..
P/code………..…………………….…………………………………
Email………………………………………………….…………………
Phones ………………………………………………………………..
(if applicable)
Lacrosse Club Affiliations
………………………………………………………………………………
Subscription for: (tick applicable)
…. 1 year ($5)
…. Lifetime ($50)
…. Lifetime incl. Club Tie & Badge ($75)
Payment
..Cash or
..Cheque or
..EFT to BSB 016112 Account 198627588
C/o The Secretary
Kuljak Lacrosse
377 Taylor Road,
Bullsbrook (East) 6084
Preferably via email to:
The Secretary - mailto:salmon3@bigpond.com