Renew Membership Step 1 of 3 33% To begin your renewal please fill out the below. I hereby apply to be renewed as a Service Member of the League and a member of the following Sub-BranchSub-Branch to renew*Select a BranchAlbanyApplecrossArmadaleBakers HillBallajuraBassendean (Eastern Regional)Bedford-MorleyBellevueBelmont (City of)BencubbinBeverleyBicton-PalmyraBoddingtonBoulderBoyup BrookBridgetownBrooktonBroomeBruce RockBullsbrook & DistrictsBunburyBusseltonCambridgeCanning DistrictsCapelCentralChidlowClaremontCockburn (City of)Collie-CardiffCottesloeCunderdinDarkanDawesvilleDenmarkDerbyDongaraDonnybrookDowerinDumbleyungDwellingupEllenbrookEsperanceFremantle CityGascoyneGeraldtonGnowangerup - BordenGosnellsGreenbushesHalls CreekHarveyHighgateJoondalup CityJurien BayKalamundaKalgoorlieKambaldaKarratha & DistrictsKarridale - AugustaKatanningKellerberrinKelmscott-RoleystoneKojonupKondininKulinKununurraKwinanaLake GraceLancelin & Coastal DistrictsLeonoraMandurah (City of)ManjimupMargaret RiverMenoraMerredinMooraMorawa - GuthaMosman ParkMt BarkerMt HawthornMt Lawley - InglewoodMundaringNannupNarroginNedlandsNew SbNewmanNollamaraNorsemanNorth BeachNorthamNorthamptonOsborne ParkPeaceful BayPembertonPerenjoriPerth (City of)PingellyPinjarraPort HedlandPort KennedyQuairadingQuinns RocksReturned Ex-ServicewomenRivertonRockingham (City of)ScarboroughSerpentine-JarrahdaleShark BaySir John MonashSouth Perth (City of)State BranchSubiaco-Shenton ParkTamminThree Springs-ArrinoTom PriceToodyayTurkishVictoria ParkVietnamese ServicesWaginWalpoleWannerooWaroona - HamelWongan HillsWubin - DalwallinuWyalkatchemWyndhamYanchep - Two RocksYokine - JoondannaYork Personal DetailsName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Nee (Maiden Name):Emergency Contact*Contact number/Email*Date of Birth* Date Format: DD slash MM slash YYYY Mail Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Work Phone (inc STD)Home Phone (inc STD)Mobile*Email* Previous Membership DetailsService Number* Membership SubscriptionMembershipMembership*1 Year Subscription3 Year Subscription5 Year SubscriptionWould you like to include a donation?No, I don't want to make a donation.$ 5.00 Donation$ 10.00 Donation$ 20.00 Donation$ 50.00 Donation$ 60.00 Donation$ 100.00 DonationTotal $ 0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Declaration and Agreement* I declare that I have not been convicted of a criminal offence and do not have charges outstanding pertaining to a criminal offence. * My application details are true and correct. * I agree to uphold the Constitution of the League and its By-Laws. We will not use any of the information on this membership form without your specific permission in writing, other than to record you as a member of the League and will not pass that information to anyone outside the League. As per By-Law 12. Annual membership $40.00 is required with this form if payment before 30 June. Pro-rata payments apply after 30 June. July-September $20.00 Oct-Dec $40.00 - covers following yearCAPTCHAPhoneEmailThis field is for validation purposes and should be left unchanged. Online form not working? You can download, complete and return this form.