Please provide details below of two of your friends that would benefit from membership at Aqualink Box Hill. We will have one of our firendly Membership Officers contact them.

We will reward you with a FREE 1 month extension to your membership each time you successfully refer two new members.

Fields marked with * are mandatory

Your Details

Name:*

Member Number:*

Telephone Number:

Email Address:*

Prospective New Members

Name:*

Telephone Number:*

Email Address:

Name:*

Phone Number:*

Email Address:

Privacy

The personal information requested on this form is being collected to enable Aqualink Box Hill to contact the people you nominate for membership or yourself regarding this enquiry. The personal information will be used by Aqualink Nunawading for that primary purpose or directly related purposes only. The information will not be released unless required by law. The applicant may apply to Council for access and/or amendments of the information.