Application
for Membership
Your Name:........................................................................................................................
Partners Name:..................................................................................................................
Address:.............................................................................................................................
.................................................................................................Post
Code:........................
Birthday (Optional) ............................................................................................................
Phone:.....................................................Mobile:...............................................................
Email
Address:...................................................................................................................
Vehicle:
Make:........................................ Rego Number:....................................................
Model:.....................................................Style:..................................................................
Colour:....................................................Year
of Manufacture:..........................................
Modifications:.....................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
I
agree to follow all club rules as published;
Signed:.................................................................Date:.....................................................
Membership Period 1st November to 31st Octobe
Annual
Fee Paid:$50
Receipt
Number:
Signature of Secretary of American Muscle Car Club of
Australia
..............................................................................Date:....................................................
Postal Address: PO Box 18 Moorebank NSW 1875
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