Sign Up Form

Private Membership

Please complete the form below to renew or commence a PBF Individual membership.

Are you an existing PBF member?
- No
- Yes
I’m sorry, but this offer is only valid for new members of PBF.
Choose your Annual Membership Option*
- Single $48 RAC offer $39
- Double $65 RAC offer $52
- Family $85 RAC offer $68
Membership Details - Person 1
Title*
Surname*
First Name*
DOB (dd/mm/yyyy)
Date Format: DD slash MM slash YYYY
Membership Details - Person 2
Title*
Surname*
First Name*
DOB (dd/mm/yyyy)
Date Format: DD slash MM slash YYYY
Children (Under 18 years only)
Surname*
First Name*
DOB (dd/mm/yyyy)
Date Format: DD slash MM slash YYYY
Surname
First Name
DOB (dd/mm/yyyy)
Date Format: DD slash MM slash YYYY
Surname
First Name
DOB (dd/mm/yyyy)
Date Format: DD slash MM slash YYYY
Surname
First Name
DOB (dd/mm/yyyy)
Date Format: DD slash MM slash YYYY
Postal Address
Address
Street Address Address Line 2 City / Town State Postcode
Phone
Email*
Tick box if you require a receipt
- Yes, I require a receipt
Newsletter
- Yes, I would like to receive updates from PBF
Donation
- Yes, I would like to make a Donation
Donation Amount
- $25
- $50
- $100
- $500
- $1000
- other
Price
After you press Submit you will be taken to the St George secure banking website
Total
$ 0.00