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Members application form

Are you a former 1st grade, reserve or part of the coaching staff? If so we want to hear from you! Enter in your details below and one of our administration team members will be in contact with you.

Your Details

    Name (required)

    Address (required)

    D.O.B. (required)

    Mobile (required)

    Home (required)

    Email (required)

    Junior Club (required)

    Years played with Manly (required)

    Appearances for Manly (required)

    Rep Honors (required)

    Polo shirt size

    What are you doing now (required)