Application for membership

APPLICATION FOR MEMBERSHIP

I wish to apply for membership to the Vintage Austin Register of New Zealand Incorporated.

Surname :
Known First Name & Initials :
Private Phone Number :
Private Postal Address :
Email Address :

Car Details	Car 1	Car 2	Car 3	Car 4
Year
Model
Style
Chassis Number
Engine Number
Car/Body Number
Number Plate
Condition
Previous Owner's Name
How Long Have You Owned The Vehicle?

Please attach photograph ( named and dated on back) of each vehicle taken within the last 12 months

Cheque attached for subscriptions: Member $45.00, Joint Membership $50.00, Overseas Membership $60.00

I agree to abide by and be bound by the constitution/rules of the Vintage Austin Register of New Zealand Incorporated and by any subsequent addition to the constitution/rules.

Signed: ----------------------------------------------------- Date : -------------

Application for membership to the Vintage Austin Register can only be accepted for approval on receipt of this form with all details entered in full.
All applicants should complete the form online then print it out, sign the form and post with a cheque made out to Vintage Austin Register of NZ Inc and photographs to :
Secretary Vintage Austin Register Of New Zealand Inc.
Judith Stephens, 217a Wainoni Road, Avondale, Christchurch. 8061 Phone 03 382 9199

Personal details are for the sole use of the Vintage Austin Register Of New Zealand Inc. and it's members as provided for in the Privacy Act 1993

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