Ford 8 & 10 Car Club Membership Application / Renewal

Name: *
Address:
Postcode:
Phone: * Email:*

Cars to be registered as club vehicles:
1. 2. 3. 4.
Year:
Model:
Registration:








I hereby agree to foster the preservation, use and enjoyment of Ford 8 & 10 horsepower motor vehicles.
New members: Please supply a recent vehicle photo for club records.

Please choose a membership option below: *
Renewal :  $NZ 60
      (current members renewing)

New member:
Jan
$35
Feb
$30
Mar
$25
Apr
$20
May
$20
Jun
$60
Jul
$60
Aug
$60
Sep
$55
Oct
$50
Nov
$45
Dec
$40

Please send me the club newsletter by email.   less $ 5
I agree to allow the club to make available my name,
address and phone number to other club members.

Total membership payment: $NZ

Please Internet Bank to:
Credit ASB Bank A/c no.:
12-3034-0535576-00

and enter your surname and phone number
in the bank details or reference fields.
SIGNATURE: