Membership Application

Name
First Last
Email*
Address
Street Address Address Line 2 Suburb NSW Post Code Australia
Phone
Date*
Forum User Name
Vehicle(s)
Model Year Body Type Engine Capacity No. of Cylinders Registration Number Category

* Category: Fill in which category (listed below) best describes your vehicle 1. Original/Unmodified 2. Restored/Period Modified 3. Modified/Custom 4. Race Car
Interests
Please indicate preferred activities or interests.
- BBQ's
- Displays
- Club Runs
- Parts Information
- Car Shows
- Technical Data
- MotorSport Events
- Historic Registration
*
- I hereby agree to abide by all Club rules and fully realise that any behaviour reflecting badly upon the club and/or its members may lead to my membership being cancelled.