Back to Contacts / Forward to Registrar Form
|
Rolls-Royce
Owners' Club of Australia, Western
Australia Branch (Inc)
|
|
|
PO
Box 590, Kalamunda WA 6926
|
|
|
Application
for Membership
|
|
| Membership Class: | Family / Single / Associate |
| Surname | (Dr/Mr/Mrs/Ms/Miss) |
| First Name (self) | First name (spouse/partner) |
| Address: | |
| No/Street: | Suburb/postcode |
| Occupation: | |
| Telephone: (Home) | (Work) |
| Fax: | Mobile: |
| Email: | |
| I, the above named applicant, have read the Constitution of the Rolls-Royce Owners Club of Australia, Western Australia Branch (Inc) and agree to be bound by the rules therein. I have also enclosed a photograph of my car/s as per Rule 6(d). |
| Signature of Applicant | |
| Signature of Spouse/partner | |
| Date | |
| Proposer (print): | |
| Seconder (print): | |
| (Both proposer and seconder must be financial members of the Club) | |
I enclose the sum of $__________________which includes $50 joining fee_____________
| Joining Fee: New member first time: | $50 |
| Annual Membership Fee: 1 July-30 June next | $140.00 (plus joining fee) |
| Pro Rata: If you join between 1 October-31 December | $105.00 (plus joining fee) |
| Pro Rata: If you join between 1 January-31 March | $ 80.00 (plus joining fee) |
| Pro Rata: If you join between 1 April-30 June | $ 55.00 (plus joining fee) |
| ___________________________________________________________________________________________________ | |
| Administration Only: | |
| Cheque Drawn By | Date Banked |
| Amount | Date Rec'd by Secretary |
| Date Approved by Committee | Date entered by registrar |
| Photo received | |