Membership Application

To become a Bairnsdale Production Line Theatre Company (BPLTC) member, and join in all that our amateur theatre company offers, fill in the online application form, below, and bank transfer your membership fees.

Membership is renewed annually either in attendance at the AGM or after via online form or emailing / posting paper form.

Become a BPLTC Member

Members 18 years and over are to provide a valid Working with Children Check or VIT membership number if participating in productions

Individual / Primary Family Member Details

First Name

Last Name

Phone

Postal Address

Town

Post Code

I am 18 years or over

Yes

Working with Children Check (WWC) Card / VIT Number

Expiry Date

If member is under the age of 18, a parent/guardian is required to enter their name, phone and email address.

Family Membership - add up to three more family members

Family Member Name (2)

WWC Check Card / VIT number (2)

Expiry Date (2)

Family Member Name (3)

WWC Check Card / VIT number (3)

Expiry Date (3)

Family Member Name (4)

WWC Check Card / VIT number (4)

Expiry Date (4)

Photo Permission: to be answered by members or parent/guardian of members under 18 years of age. I I give BPLTC permission to use photos of me/my child for the purposes of promoting any performances, programmes and fundraising articles produced by them.

Donation: I would like to donate to the BPLTC and will transfer this amount with my fees.

Photo Permission

Yes

Donation

Privacy: BPLTC is committed to protecting the privacy of personal information which the organization collects, holds and administers. BPLTC will safeguard the information we collect and store against misuse, loss, unauthorized access and modification and will destroy records once they are no longer required.

Not submitting - check any entries or fields showing red

Thanks for applying to be a member of BPLTC! We'll get back to you soon.

Bank Transfer Details
Please use LAST NAME as reference on payment.
Bendigo Bank

BSB:633 000

ACC:107968885

ACC NAME: Bairnsdale Production Line Theatre Co

Fees:

Single $30
Concession $25
Junior (under 18) $20
Student (any level, 18+) $20
Family (up to four members) $40