Join: Online Form

Note: DO NOT print out this page, this form is to be completed electronically. If you are looking for a paper form to print out, please go to Membership application form

How many residents are applying?*
Please choose how many residents you would like to include with this Membership application form. Once a number is selected, fields for each resident's personal details will appear.
Your Details
Name*
Title Given Name Family Name
Membership Status*
- New Member
- Renewing Member
Please tell us if you are a new member or renewing an existing membership:
Email Address*

Please note: SRA Bulletins will be emailed where possible and no longer posted.
Contact Phone or Mobile No.*
Postal Address*
Street Address Township / Suburb State Postcode
Resident #2 Details
Name*
Title Given Name Family Name
Membership Status*
- New Member
- Renewing Member
Please tell us if you are a new member or renewing an existing membership:
Email Address*

Please note: SRA Bulletins will be emailed where possible and no longer posted.
Contact Phone or Mobile No.*
Postal Address (if different from above)
Street Address Township / Suburb State Postcode
Resident #3 Details
Name*
Title Given Name Family Name
Membership Status*
- New Member
- Renewing Member
Please tell us if you are a new member or renewing an existing membership:
Email Address*

Please note: SRA Bulletins will be emailed where possible and no longer posted.
Contact Phone or Mobile No.*
Postal Address (if different from above)
Street Address Township / Suburb State Postcode
Resident #4 Details
Name*
Title Given Name Family Name
Membership Status*
- New Member
- Renewing Member
Please tell us if you are a new member or renewing an existing membership:
Email Address*

Please note: SRA Bulletins will be emailed where possible and no longer posted.
Contact Phone or Mobile No.*
Postal Address (if different from above)
Street Address Township / Suburb State Postcode
Resident #5 Details
Name*
Title Given Name Family Name
Membership Status*
- New Member
- Renewing Member
Please tell us if you are a new member or renewing an existing membership:
Email Address*

Please note: SRA Bulletins will be emailed where possible and no longer posted.
Contact Phone or Mobile No.*
Postal Address (if different from above)
Street Address Township / Suburb State Postcode
Resident #6 Details
Name*
Title Given Name Family Name
Membership Status*
- New Member
- Renewing Member
Please tell us if you are a new member or renewing an existing membership:
Email Address*

Please note: SRA Bulletins will be emailed where possible and no longer posted.
Contact Phone or Mobile No.*
Postal Address (if different from above)
Street Address Township / Suburb State Postcode
Your Property Information
Somers Property Address*
Street Address Township / Suburb State Postcode
Somers Property Address Status*
- Permanent resident of Somers (own home)
- Holiday or part time resident of Somers (own home)
- Property owner in Somers but do not live or holiday in Somers
- Tenant in Somers
Payment Information
You can submit your subscription fee ($10 per person) to us either electronically by bank transfer or by post.
How would you like to pay your subscription?*
- Direct Deposit (EFT)
- Cheque via AusPost
To pay by cheque, please write your cheque out to Somers Residents Association Inc and post your cheque to :

The Secretary
Somers Residents Association
PO Box 294,
Somers VIC 3927

Or envelopes can be left in the drop box at the Somers Fire Station meeting room entrance door. However please ensure all payment is accompanied by a membership form so we can associate your name with the payment.
To pay by direct deposit, please direct your payment to the following bank account:

Account Name : Somers Residents Association Inc
BSB : 633-000
Account Number : 145222196

Please ensure that you clearly list your name in the description field of the bank transfer so that we can associate the payment with your enrolment.
Donation Amount
Total Amount Payable
$ 0.00
To finalise your application, please press the submit button. You will receive a follow-up email with further information on bank and payment details.
Submit your application

Somers Residents Association Inc
No. A0043436R
ABN: 88 697 187 843

PO Box 294, Somers VIC 3927
info@somers.org.au

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Join: Online Form

Your Details

Resident #2 Details

Resident #3 Details

Resident #4 Details

Resident #5 Details

Resident #6 Details

Your Property Information

Payment Information

Submit your application