Kampung Utara Melbourne - Membership Form

Membership Form

Fields with * are compulsory

Full Name *

Email *

Phone *

Date of birth *

Marital Status *

Spouse Name *

Your Occupation *

Street Address *

City

State

Country

Postal code

Australian Residency Status *

Please list your children's names and their date of birth.

What year did you first participate in KUM's activities?

What types of activities would you like to participate in with KUM?

1/38 Zakwell Court, Coolaroo, VIC 3048