My Voluntary Increased Commitment My Voluntary Increased CommitmentI/We are filling this in for: Personal CompanyFirst Name(s)SurnameEmail addressMember NumberPhoneChurch- Select -ArmadaleComet BayCardup BrookBaldivisBunburyBusseltonByfordDarling DownsKelmscottMelvilleMt NasuraMundijongRockinghamSeville GroveSouthern RiverAlbanyWest AlbanyCompany/Entity Name(s)Business Owner NameEmailPhoneStreet AddressSuburbState- Select -WATASQLDNTACTNSWVICSAPostcodeVoluntary CommitmentI/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- Select -WeeklyFornightlyMonthlyYearly (in advance)My payments will commencePlease Note: 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. SignatureDateSubmit Application