Joining Fee : $35. Annual Fee : $25.
| Name : | Date of Birth : | __ / __ / xxxx | |
| Partner's Name : | Date of Birth : | __ / __ / xxxx | |
| (year not required) | |||
| Address : | |||
| Post Code : | |||
| Phone : | |||
| Mobile : | |||
| e-mail : | |||
| Year | Make | Type (eg Tourer) | Condition (Restored/Original) | Registration Number |
Are you a member of any other car club/s (other than RACQ) ? YES / NO (Please circle)
If yes, which clubs : _________________________________________________________
The Club publishes (only amongst members) a register of members, (their phone numbers and the Historic/Classic cars they own). Are you happy to have your details published in the register? YES / NO
NOTE: It is Club policy to ensure correct use of concessionally registered vehicles and in light of Transport Department regulations members are reminded that "Failure to comply with the conditions of the Special Interest Vehicle Scheme is an offence and serious consequences may result".
It is also expected that members participate in at least FOUR Activities (Events/Meetings/Runs) each year.
I/We undertake to abide by the rules laid down in the Club's Constitution and will take an active role in the Club's activities.
Signature: ________________________________ Date: ____/____/____
| Proposed by : | Seconded by : | ||
| Date : | ___ / ___ / ___ | Date : | ___ / ___ / ___ |
| Accepted / Rejected : | Date : | ___ / ___ / ___ | |
| Receipt No : | Entered in database : | YES / NO |
The club meets - on the second Friday of every
month at at the
Donald Simpson Centre, 172 Bloomfield Street, Cleveland, at 7.30
pm.