VINTAGE VEHICLE CLUB OF AUSTRALIA 1919-1930 Inc

DEDICATED TO THE PRESERVATION OF VINTAGE VEHICLES 1919-1930

 

Personal Details

Last Name:

 

 

Given Name:

 

Nickname or preferred Name:

 

 

Partner's Name:

 

Address:

 

 

State:

 

 

Post Code:

 

 

Contact Details

Home Tel:

 

 

Work Tel:

 

Email:

 

 

Mobile Tel:

 

 

Type of Membership

Please tick or cross applicable box.

Full Membership - I own a Vintage Vehicle.

 

 

Associate Membership - I don't own Vintage Vehicle, but interested in them.

 

 

Are you Transferring to:

Full

Membership

 

Associate

Membership

 

 

 

Vehicle Details

Make of Vehicle:

 

 

Body Type:

 

eg Sedan, Tourer, Roadster, etc

Engine Number/s:

 

 

Chassis Number/s:

 

 

Condition of Vehicle:

 

 

eg Roadworthy, registered, original, restored, under restoration, etc

Interesting Features/Info/History:

 

 

 

(Please add extra page/s if necessary)

Please send this completed application form with payment to:

The Vintage Vehicle Club of Australia

c/- 134 Queens Road, Five Dock, NSW, 2046.

Cheques or money orders to be made payable to: The Vintage Vehicle Club of Australia