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 $40.00 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
