www.montrosefc.org.au Montrose Recreation Reserve 950 Mt Dandenong Tourist Road, Montrose 3765 email: [email protected] ABN: 52 225 945 848 2015 Membership Application Form Please Note: A separate membership form must be provided for each person that is applying for membership Surname: First Name: Address: Suburb: Postcode Telephone: Home: Work: Mobile Email Address: Occupation: AFL Club supported: Would you like to be contacted regarding Club Sponsorship Packages? YES  NO  By signing this form the Member and/or Player acknowledges the acceptance of the Montrose Football Club Code of Conduct and that they, accompanied family members and visitors agree to abide by the Rules and Regulations of the Eastern football League (EFL) and Montrose Football Club Inc. Signature:____________________________________ Date: ____________________________ Please tick or cross box for your selection     Includes: Gate entry to all senior home games; One beverage at those home games; Entry in the Friday Night Members' Draw            STANDARD MEMBERSHIP $120.00   SOCIAL CLUB MEMBERSHIP $30.00 Includes: Entry into the Ken Dowling Pavilion; Entry into the Friday Night Members' Draw (Gate entry to senior home games and voting rights are NOT included) JUNIOR PARENT MEMBERSHIP U9's - U17's  CLUB 300 MEMBERSHIP $350.00 Includes: Gate entry to all senior home games; Zoned viewing access from upstairs balcony and waiter service; One beverage at those games Half time refreshments Exclusive 300 Club polo shirt or scarf and stubby holder Invitation to the Club 300 Luncheon One Guest Pass for one senior home game Entry into the Friday Night Members' Draw Opportunity to network with other Club 300 members    (COMPLIMENTARY) NOTE: *Form must be completed in an Adults name, not the junior players name. If you are intending to purchase a Club 300 Membership, please nominate your partner as the Junior Member. Includes: One complimentary membership per family Gate entry to all senior home games; Entry into the Friday Night Members' draw.  Junior Player Name: ________________________________ Junior Player Team: UNDER ________  Please indicate your preference:   Club 300 Polo Shirt: S  M  L  XL  XXL  XXXL  OR JUNIOR PARENT MEMBERSHIP U8's (COMPLIMENTARY) Includes: Entry into the Ken Dowling Pavilion; Entry into the Friday Night Members' Draw (Gate entry to senior home games and voting rights are NOT included) Scarf and Stubby Holder  Junior Player Name: ________________________________ PLEASE PROVIDE YOUR PAYMENT DETAILS BELOW Cash Card Number: _ _ _ _ ☐ Cheque / _ _ _ _ / _ _ _ _ ☐ / _ _ _ _ Visa ☐ MasterCard Expiry date: _ _ / _ _ ☐ EFT ☐ CCV: _ _ _ Cardholder’s Name: ________________________________Signature: _________________________________ AMOUNT: $ _____________ **EFT Payment: Montrose Football Club BSB: 633-000 Account No: 130722143 Postal: Please post completed application form to: Montrose Football Club P.O. Box 77 Montrose Vic 3765 ** Please quote your name eg. J&ESmithMFC Member as the reference when paying via EFT Email: [email protected] OFFICE USE ONLY Date Paid: Via: Card no: Date Issued: