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Test New Membership Form – Please play if you must

New Membership Form

 

Queensland Billiards & Snooker Association Inc.

Individual's personal information will remain confidential and shall only be used by
the QBSA for member's records. General statistics may be used in requests for funding.
Membership
Membership Number
Name:*
Address:
Phone:*
-
E-mail:*
Club:
Date of Birth*
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Membership Fees are as follows: Under 18 $10  Other $30
Cheques payable to QB&SA Inc. mailed to: PO Box 417, Spring Hill   Qld   4004
Direct Deposit: Westpac Bank bsb: 034086 Account: 146996 Rererence: your name
Select Payment Option:

By clicking the submit key, I acknowledge that I have read, understood and will abide
by the rules and regulations applicable to my QB&SA Inc. membership

Date Acknowledged & Submitted*
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