All past players and officials from Fitzroy, Brisbane Bears, and the Brisbane Lions are invited to become part of our new-look Association designed exclusively for those who have made a valuable contribution to the Club - both on and off the field - throughout our unique history. Annual membership is just $20 and includes a range of benefits including: Free entry into the Members’ Social Club at the Gabba at 2019 Brisbane Lions home games Past Players & Officials membership card Opportunity to promote within the Past Players & Officials Business Directory Exclusive Past Players & Officials members’ lapel pin Discounts to select functions throughout the season CONTACTS AFL Players Association Brisbane Lions Brad Fisher c/Melbourne Office P: 03 8850 5600 P: 03 8651 4366 740 Bourke St, Docklands VIC 3008 E: [email protected] E: [email protected] W: lions.com.au/pastplayers c/- Marvel Stadium T: 03 8850 5600 740 Bourke Street, Docklands VIC 3008 E: [email protected] MEMBERSHIP SELECTION DESCRIPTION QTY COST/ITEM (INCL GST) SUBTOTAL 2019 Past Player & Officials Membership $20 2019 Historical Society Membership $20 Donation(should you wish to provide one) TOTAL (INCL GST) $ CLUB HISTORY Please tick the box/es below that best outlines your past involvement/association with the Club FITZROY (1883-1996) BRISBANE BEARS (1987-96) BRISBANE LIONS (1997-Today) Past player (senior/reserves/U19) Past player (senior/reserves/U19) Past player (senior/reserves/AFLW) Past Official (please specify below) Past Official (please specify below) Past Official (please specify below) Official role: CONTACT DETAILS NAME ADDRESS SUBURB STATE P/CODE TEL (HOME) MOBILE EMAIL I do NOT want my personal details provided to any fellow past players or officials if requested PAYMENT DETAILS Amex Cheque / Money Order Visa / MasterCard Cash (3% surcharge) (payable to the Brisbane Lions AFC) Direct transfer: Bank of Queensland - BSB: 124 001 - A/C No: 11 271 985 Transfer Date: Card Number Expiry Cardholder: Signature: Date: PRIVACY POLICY: The Brisbane Lions have a Privacy Policy. Where we collect your personal information we will act in accordance with that policy. Please call 07 3335 1777 or email [email protected] to request a copy of our Privacy Policy. .