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

               DBTC_letterhead_logo_copy                 
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: September Ist  Includes Printed Newsletter x 4    $50.00 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 $17.00 for NHMA insurance if needed   .......

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:-

Tom Williams

The David Brown Tractor Club of Australia

120 Mansfield Street
INVERELL   NSW   2360

 

(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: (02) 6722 1476 Mobile: 0428 669 404 Email: meander24@bigpond.com

____________________________________________________________________________________________________________

CLUB PRESIDENT: Tom Oram, Deniliquin NSW      PHONE: 0358817803

 
 
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