Online Membership Form Ballarat Agricultural & Pastoral Society Membership purchase form. MEMBERSHIP DETAILSName* First Last Date DD slash MM slash YYYY Address* Street Address Address Line 2 City State / Province / Region Postal Code Email* Enter Email Confirm Email Phone or MobilePAYMENT DETAILSSelect your membership*Annual MembershipNew Youth SubscriptionGold MembershipPlease select the type of membership you would like to purchase below.Total $ 0.00 SignatureTerrms and Conditions* Accept Terms I renew my Membership of the Ballarat Agricultural and Pastoral Society Inc. and I agree to be bound by the rules and regulations of the Society from time to time in force and to abide by such rules and regulations. I understand that my membership card is not transferable and I shall not permit my membership card to be used by anyone other than myself.NameThis field is for validation purposes and should be left unchanged.
