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Membership
Application Form
Please
print Clearly
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Personal Details |
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Last Name: |
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Given Name: |
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Nickname or preferred Name: |
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Partner's Name: |
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Address: |
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State: |
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Post Code: |
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Contact Details |
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Home Tel: |
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Work Tel: |
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Email: |
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Mobile Tel: |
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Type
of Membership
Please
tick or cross applicable box. |
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Full
Membership - I own a Vintage Vehicle. |
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Associate
Membership - I don't own Vintage Vehicle, but am interested
in them. |
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Are you
Transferring to: |
Full
Membership |
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Associate
Membership |
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Vehicle Details |
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Make of
Vehicle: |
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Body Type: |
eg Sedan,
Tourer, Roadster, etc |
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Engine
Number/s: |
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Chassis
Number/s: |
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Year of
Vehicle:
Condition
of Vehicle: |
eg
1926, roadworthy,
registered, original, restored,
under restoration, etc |
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Interesting
Features/Information/History and Photographs. |
(Please
add extra page/s if necessary and include any
photographs you might have of your car.) |
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Please
send this completed application form with payment and a photograph of
your car to:
The
Vintage Vehicle Club of Australia 1919 - 1930
c/-
134 Queens Road, Five Dock, NSW, 2046.
or
bring it to the next meeting.
Cheques
or money orders to be made payable to: The
Vintage Vehicle Club of Australia
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