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MEMBERSHIP APPLICATION / RENEWAL

(memberships run 1st July to 30th June)

 

NEW MEMBERSHIP / RENEWAL (circle)

 

Name:…………………………………………………………………………

 

Address:………………………………………………………………………

 

……………………………………………..Postcode:………………………

 

Telephone:………………………………….Fax:……………………………

 

Email:……………………………………………………

 

Car Details: (if you have a GT40) …………………………………………..

 

I am interested in:                    Social (picnics/Sunday Drives/etc)

 

          Sporting Events

 

Suggestions Welcome:………………………………………………………

 

……………………………………………………………………………….

 

Fees:                Membership      $50.00 per year

 

I the undersigned wish to become a member of the Club GT40 Inc of Queensland Australia. 
I understand the nominated membership payment and agree that if accepted,
 I will abide the terms and conditions of the club.


 

Signature of applicant:……………………………………………………Date:……/………/……..

 

 

 

Payment by:                 Cash                            Cheque


Direct Payments can be made to:

BSB>  124001

Account no>  90640317


Please print this screen and post to:

Club GT40
25 Marwood Street
Belmont Qld 4153

You dont have to own a GT40 to become a member

 

 

 

 


 
       

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