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Complete the Membership Application

Form (PLEASE USE BLOCK LETTERS), and send it with your $5 application fee + $50.00 joining fee to:

1949 – 1962 Ford V8 Club of NSW INC

7 CHRISTIE ST RAGLAN NSW 2795

OR

48 Currawang St Concord West NSW 2138

Name_______________________________ DOB__________________

Partner______________________________ DOB__________________

Address____________________________________________________ _______________________________Postcode____________________

Phone No__________________________________________________

I wish to join as a: Full Member /M2/ Associate Member (circle one)

I am present owner of: Model_________________ Year____________

Registration_______________ Body Style ________________________

State Original &/or modifications_______________________________ __________________________________________________________

__________________________________________________________

__________________________________________________________

I, __________________________________, hereby apply to become a member of the above named Incorporated Association. In the event of my admission as a member, I agree to be bound by the rules of the Association for the time being in force.

            Signed_______________________________________________

            Date_________________________________________________ Nomination by Club member/s for applicants’ membership:

I, ______________________________________, being a financial member of the 1949 – 1962 Ford V8 Club of NSW INC, hereby nominate ________________________________________ for application of membership to the 1949 – 1962 Ford V8 Club of NSW INC.

Signed______________________________________________

Dated_______________________________________________

I, ______________________________________, being a financial member of the 1949 – 1962 Ford V8 Club of NSW INC, hereby second the application for membership of______________________________ to the 1949 – 1962 Ford V8 Club of NSW INC.

Signed______________________________________________

Dated CLUB USE ONLY:

Date received_____________________________________

Membership No. Issued_TBA____________________________

Membership No. Issued_TBA____________________________