Membership form | The Vintage Austin Register of NZ

Please fill in form and submit online.

Please direct debit subscription to Westpac A/c 03 0687 0289823 00 stating name and "new member" in reference fields.

If paying by cheque please send to the Secretary. (address on home page)

Please note: your membership will be processed on receipt of payment.

Subscriptions: Member $45, Joint $50, Overseas $60

Condition of car (see below) : original, restored, under restoration, parts.

If you have more than one car please leave double space between each car detail.

*(denotes required field)

First Name: *

Middle Initial:

Last Name: *

E-Mail Address: *

Postal Address *

City/ Town *

Postcode *

Phone number

Mobile number

Year of car/ or enter "have no car" here *

Model (if no car enter "na" ) *

Style *

Chassis number *

Engine number *

Car/body number *

Number plate *

Condition (see above) *

Previous owner's name *

How long have you owned the car? *

I/we agree to abide by and be bound by the constitution/rules of the VAR NZ Inc. (your name in field please) *

Type of membership required *

Payment made by *

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