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Online Membership Application
Name
(Required)
First
Last
Village or Park Name
(Required)
e.g. Regal Waters, Bethania
Site Number
(Required)
e.g. 145
Internal Street Name
e.g. Trafalgar Ave
Village or Park Address
(Required)
e.g. 16 Holzheimer Road
Suburb
(Required)
e.g. Bethania
State
(Required)
QLD
NSW
VIC
ACT
SA
WA
e.g. QLD
Postcode
(Required)
e.g. 4205
Phone
(Required)
Your best phone number if we need to call you
I have an email address
(Required)
Yes
No - Please use - membership@arpq.org.au - in the email field below and we will post your receipt to you.
Email
(Required)
Note: If you don't have an email address, please use - membership@arpq.org.au
PERSONAL MEMBERSHIP FEE - $15.00 per year (year ends 30th September)
Payment Method
(Required)
Direct Deposit
Cheque
Money Order
Credit Card
# Reference: If paying by direct deposit please use your last name as a reference. If paying by cheque please write your Association name or your full name on the back of the cheque
PERSONAL MEMBERSHIP FEE
Coupon
Total
Credit Card
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
Security Code
Cardholder Name
Home
About ARPQ
Presentation
Membership
Advocacy
Resources
Bulletins
Contact Us
Menu
Home
About ARPQ
Presentation
Membership
Advocacy
Resources
Bulletins
Contact Us