Membership Application Form

$Paul Cauchi stories - DB\'s in the 50\'s 60\'s & 70\'s$

Feel free to print off a copy of this form, which can be mailed along with your payment.


	Incorporation No 9892417 MEMBERSHIP APPLICATION The DAVID BROWN TRACTOR Club of Australia All Membership Fees are Due & Payable by 1st July each year, to bring it into line with NHMA financial year. SURNAME :________________________________________ FIRST NAME: ______________________________________ ADDRESS:______________________________________________________postcode_________ POSTAL ADDRESS: (if different from above) __________________________________________________ _______________________________________________________________________________________ PHONE NUMBER:___________________________________________________ MOBILE NUMBER___________________________________________________ EMAIL:___________________________________________________________ If you can supply an email address, we can email your newsletter and other information Tick *Membership Cost: Due: July Ist Includes Printed Newsletter x 4 $70.00 per year. ....... Or if you choose to receive newsletters by email - $40.00 per year ....... Associate member (non-voting spouse or family member) $10.00 per year .......* Plus $18.00 for NHMA insurance if needed ....... To encourage new Junior Members we have added a junior category: Junior member to 16 years of age (will receive newsletters by email) No Charge ....... Please advise birthdate ............................................... TRACTOR REGISTER (OPTIONAL) MODEL/S:___________________________________________________________________ ____________________________________________________________________________ SERIAL NUMBERS (IF POSSIBLE)_______________________________________________ ____________________________________________________________________________ I would like to include my name & phone no. in a register for club members only: YES / NO SIGNATURE:_____________________________________ DATE:__________________ Return this form with remittance to:- Peter Gardiner David Brown Tractor Club of Australia PO Box 148 COLAC VIC 3250 (Make cheque or money order to David Brown Tractor Club of Australia Inc) BSB: 062-556, A/c#: 1032 6432 (Please add Surname as Reference) Ph: (03) 5231 3827 Mobile: 0428 553 694. Email form to Robyn Cole: meander24@bigpond.com ____________________________________________________________________________________________________________ CLUB PRESIDENT: Tom Oram, Deniliquin NSW PHONE: 0358817803

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