Moora Moora Friend application

If you wish to become a Friend of Moora Moora, please fill in the following details after you have deposited $200 as a Friend's Loan in our bank account. The loan bears no interest and is repayable with three months' notice.

BSB: 633000  
Account: 143417764  
     
Deposited:  
Name:    
Address:
Suburb:  
Landline:  
Mobile:  
Email:  
Are you interested in joining or supporting us?
   
Please tell us how you heard of us and why you want
  to become a Friend?
 
Today's┬ádate:    
 

(Please note: Friendship and membership at Moora Moora is per person. If you are a couple, each person will need to pay and fill in this form separately.)