ASRCC Membership form

A.S.R.C.C MEMBERSHIP APPLICATION / RENEWAL FORM

  PRICES ARE FOR AUSTRALIA ONLY. CONTACT CLUB FOR INTERNATIONAL PRICE AND POSTAGE.

Membership Fees are:
Australia – Single Membership   $40.00
Australia - Family Membership   $50.00
Membership runs from January 1st to December 31st. (includes Club Lines Newsletter)

For new members, or rejoiners, after 30th June please contact Membership Secretary.
The Club reserves the right to refuse applications at its discretion.

Payment: Cheques and Money Orders made payable to “CLUB LINES”
Note: We cannot accept cheques/money orders made out to ASRCC.
OR
by direct transfer to:
Commonwealth Bank BSB: 062589 Account: 10186201.
Please reference payment with surname of applicant.

Please complete either the following application /renewal form and click Submit to send it electronically,
OR
complete the details at the bottom of the page and post together with your payment to the address listed below.

Membership
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Name: ............................................................................................................
Address: .........................................................................................................
.......................................................................................................................
.......................................................................................................................
E-Mail: ..........................................................................................................
Membership Number: .......................................................
Telephone (home):..............................................................
(mobile): ............................................................................
(work): ..............................................................................

 

POST TO:

The Secretary
PO Box 577,
Wentworthville
NSW.
2145 Australia