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Lilydale RSL

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Service Application Form

Homepage | Membership | Service Application Form

Lilydale RSL
SERVICE APPLICATION FORM

Service Requirements Available to past or present serving members of the Australian Defence Force and Allied Armed Forces.

Applicants are required to provide documentary evidence of service history.

Please enable JavaScript in your browser to complete this form.

Have you been a member of the RSL before? *

Yes
No

PREVIOUS RSL DETAILS

State *

Sub-Brand Name *

Sub-Branch Joining

Membership Category *

Affiliate
Service

Period *

1 Year
3 Years

YOUR DETAILS

Title *

Mr
Mrs
Ms
Miss
Other

Full Name *

First

Last

Preferred Name *

Post Nominals (suffix) *

Gender *

Male
Female

Date of Birth *

ADDRESS

RESIDENTIAL ADDRESS *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Same Address

Postal address is the same as my residential address

POSTAL ADDRESS

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

CONTACT DETAILS

Mobile *

Home

Business

Email *

Preferred Contact Method

eMail
Mail
Phone

NEXT OF KIN DETAILS (OPTIONAL)

Full Name

Contact Number

Relationship

SERVICE DETAILS

Service Force *

Australian Defence Force
Allied Armed Force

Service *

Army
Navy
Air Force
Merchant Navy

Country *

Service Number *

Current / Discharge Rank *

Unit/Ship *

Date Enlisted *

Date Discharged *

Service Awards

Service Locations

Relationship Enlisted been

SIGNATURE

Signature *

Clear Signature

Checkboxes *

I declare that the information provided is true and correct, and I agree to uphold the Constitution of the League and its By-Laws

Located at the gateway to the Yarra Valley the Lilydale RSL has been in operation since 1919 and is a traditional non-pokies venue with limited operating hours with some of the best bar prices in the area.

Contact Us

52 Anderson Street, Lilydale, Vic 3140
PO Box 88, Lilydale, Vic 3140 03 9739 5680
info@lilydalersl.com.au

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