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Lofty Legends
“Supporting a confident future built from a rich heritage.”
2015 MEMBERSHIP APPLICATION FORM
Full Name
(Mr/Mrs/Ms) Full name:………………………………………………..……………………………………………..
If renewing membership and your details have not changed no further contact detail is required below:
Contact
Numbers
E-mail address
H……………………………………………………
M……………………………………………………………………….
…………………………………………………………………………………………………………
If you would like correspondence posted
rather than e-mailed, please provide your
address details.
…………………………………………………………………………………………………
……………………………………………………………………PCODE: ………………
Membership (from 1 April 2015 to 31 March 2016):
Joining as a member of the Lofty Legends Group will see your membership fee support the annual reunion of
heritage club past players, officials, members and supporters, and will make a small contribution to the
running of the football club. Our Legends will receive a membership card providing free admission to all
home matches and the “Lofty Legend” newsletter. All funds will be receipted and banked by the Treasurer
into the club’s bank account. N.B. Membership of “The Lofty Legends” does not provide membership of the
Mt.Lofty DFC or associated voting rights of the Mt.Lofty DFC.
Annual membership Fee: $25 (Concession membership of $15 is also available to Life Members, paid up
members of the Mt.Lofty DFC, “100 Club” members, and concession card holders )
Please post this form to “The Lofty Legends Group”, Mt.Lofty District Football Club, PO Box 715, Stirling SA
5152 and arrange payments by:


Enclosing a cheque made payable to Mt. Lofty District Football Club, OR
Making an EFT to Mt Lofty District Football Club ANZ BSB: 015367 Account No: 484620862. Please
include your name in the transfer. Date transferred ………./……….../………………
Other detail you might like to provide:
Club/s involvement:
…………………………………………………………………………………………………………… From……………………To………………………..
…………………………………………………………………………………………………………… From……………………To………………………..
Please tick here if you would like to carry out some “one off” or ongoing tasks to assist the club?
If “yes” please indicate:
Skills and/or areas of interest which you
would like to offer assistance in:
Yes
Any particular activities or tasks you might suggest you would
like to carry out or assist in?