mobile-logo

Online Membership Application/Renewal

Donations

Donations for ongoing support & maintenance are always appreciated & gratefully accepted.

Annual membership fee

Single $40 / Family $65 / Organisation $95

Organisations must be a not-for-profit Community Group.

Please complete the Membership Application/Renewal below:

Even if renewing, please provide all details to ensure that we have your most up-to-date contact information, thank you.

When you click ‘Submit’ below, you will automatically be sent a confirmation email containing the information you have provided, as well as payment instructions.

Available payment options are also listed below this form.

    Contact name*

    Membership type* Individual $40Family $65Organisation $95Donation Only

    Please indicate the number of people that this membership covers (ie: Family or Organisation size)*

    New or existing member* NewExisting

    Membership Number (if existing)

    Payment amount $

    Organisation name (For organisational membership only)

    Organisation website (For organisational membership only)

    Organisation Facebook (For organisational membership only)

    Do you wish to have AGM voting rights* NoYes

    Email*(Please ensure that it is correct)

    Phone*

    Postal address*

    Family member names & birthdays (Birthdays optional for our on-air Birthday Book shout-out)

    Your favourite South Coast FM Show(s)

    Spam protection*. What is

    Hint: Melbourne | Sydney | Brisbane | Perth | Adelaide | Darwin | Hobart


    Click 'Submit' when ready to send the application to us. You will automatically receive a confirmation copy via email.

    Payment options

    Payment by Bank Transfer (preferred):
    Account name: South Coast FM / BSB: 633-000 (Bendigo Bank) / Account number: 109264341
    Please include your membership name as the Transfer Reference.

    It would help us greatly, if you would please also email us at Accounts@SouthCoastFM.au with payment details including your name & the amount when you pay via Bank Transfer. Thank-you in advance.

    Payment by cheque:
    Cheque made out to ‘South Coast FM’
    Posted to South Coast FM, 239 White Rd, Wonthaggi VIC 3995
    Please include your membership name & number on the rear of the cheque.