NEW MEMBERSHIP APPLICATION
NO.
/
MG CAR CLUB NEWCASTLE INC ABN: 96 210 450 708
Club Phone (02) 49635380
Website: www.mgcarclub.com.au
PLEASE COMPLETE ALL DETAILS & RETURN TO: Joy Bower 11 Nathan Close, Metford. NSW 2323
For all membership enquiries please phone (02) 49332346
Personal Details (all applicants to complete this section)
1st Membership Details:
Surname (Mr./Mrs./Ms/Miss) ____________________________ Given Names____________________________________
Address____________________________________________________________________________Post Code__________
Phone:Home__________________Work________________Mobile_____________________Occupation________________
Email address 1st member______________________________________2nd member________________________________
2nd Family Member Details:
Surname (Mr/Mrs/Ms/Miss) _____________________________Given Names_____________________________________
Phone: Work______________________Mobile_______________________Occupation______________________________
DETAILS OF CAR. Do you own an MG YES/NO.? Model_____________________________________________________
Please contact Register Secretary for enquiries regarding Historic Plates with details of your vehicle/s. Consult web site
OTHER VEHICLE Make and Model__________________________________________________________________________________
I/We hereby apply for membership of MG Car Club Newcastle. MEMBERSHIP QUALIFICATIONS. Any person who is or has been
an owner of an MG Motor Car or who is in sympathy with the objects of the club and agrees if accepted to abide by the rules of
the Club
Signature (1st applicant) ____________________________ (2nd applicant) ______________________________ Date ________________
The above named applicant/s is/are nominated for Membership of the MG Car Club Newcastle by:
(1) Name__________________________________ Member No. _____________ Signature_________________________ __
(2) Name __________________________________Member No.______________Signature____________________________
(The above nominators must be financial members of the MG Car Club Newcastle)
Magazine Delivery (Please circle preference)
Mail
Website
____________________________________________________________________________________________________
JUNIOR MEMBERS – must be under 18 years on 1stMarch. Parent/Guardians to complete.
I, (print full name) ___________________________________ am the parent/guardian of the above junior member and I
hereby consent to the above named minor joining the MG Car Club Newcastle. Junior D.O.B _______/______/_________
Signature of Parent/ Guardian if Junior Applicant (under 18 years of age)
Signature____________________________________________________ Date ______________________
CLUB FEES –DUE PER ANNUM from 1stMarch to 1st March following year (Includes GST)
JOINING FEE
$25.00 (
) NEW MEMBERS ONLY (EXCEPT JUNIORS)
FULL MEMBERSHIP – own or owned MG
$55.00 (
) MG Owner
ASSOCIATE MEMBERSHIP
$45.00 (
) Non MG Owner
FAMILY (2 MEMBERS) – FULL
$65.00 (
) MG Owners
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FAMILY (2 MEMBERS) – ASSOC
$55.00 (
) Non MG Owners
Tick
one
JUNIOR MEMBERSHIP
$20.00 (
) No joining fee
Credit card Administration Fee
$3.00 (
)
TOTAL PAYABLE
$______________ Cheque / Credit card/ Cash
st
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st
Note: After 1 January club fee will cover to 1 March of the following year
CREDIT CARD MAIL ORDER AUTHORITY - Please Debit my card a total $ ____________________
(Please add Credit Card Fee)
Cardholder’s Name (as shown on Card) ________________________________________________________
]
Receipt No:
Card Number _____________________________________________________________________________
Cardholder’s Signature_______________________________________Expiry date__________/__________
Office Use Only
Interim Receipt / Membership
Tear off section
Received from………………………………………the sum of $………. 00 for…………………………membership
Of MG Car Club Newcastle.
(Full. Associate, Junior)
This membership is subject to acceptance by MGCC Newcastle committee at next monthly committee meeting
Signed…………………………………………… Club Position……………………………. Date………/……/…200
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