My Voluntary Increased Commitment

I/We are filling this in for:

Personal

Company

First Name(s)

Surname

Email address

Member Number

Phone

Church

Company/Entity Name(s)

Business Owner Name

Phone

Street Address

Suburb

State

Postcode

I/We are committing to a Voluntary Commitment:

$260 per year ($5 per week)

$520 per year ($10 per week)

$1,040 per year ($20 per week)

$2,600 per year ($50 per week)

$5,200 per year ($100 per week)

Other Amount (Per Year):

Other Amount ($)

I/We will pay this: Frequency of Payment

My payments will commence

Please ensure your voluntary increased commitment is paid to the Building Fund account: BSB 036-224 Account: 174944
Please include your member number in your payment description.
If you are submitting this form under your business name, a separate account will be established.
Following the submission of your application, you will receive an email from the FRSA finance team with an updated statement reflecting your voluntary increased commitment.

Signature

Date