join modern pentathlon australia

denotes mandatory fields

Become a Modern Pentathlon Australia member on-line using this form, or print out the application form available below. (Membership forms will be processed by MPA & lodged with your local State Secretary/Club Captain).

Prefix:	select Mr. Mrs. Miss. Ms. Dr. Prof.
Surname:
Given Names:
Company Name:
Birth Date:
Gender:	male female
Address:
City:
Postcode:
State:	select ACT NSW NT QLD SA TAS VIC WA
Office Phone:
Home Phone:
Fax Phone:
Mobile Phone:
e-mail Address:
Marital Status:	select Single Married Defacto
Spouse's Name:
No. of Children:
Preferred Member Type:	select Athlete Member Family Student Junior Other
Favourite Discipline:	select Shooting Fencing Swimming Riding Running

print membership form

MPA printable membership form:

Forward applications to:
Modern Pentathlon Australia
P.O. Box 3010 Domain Road,
South Yarra, Victoria, Australia 3141