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

Incorporation No 9892417



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: ______________________________________


POSTAL ADDRESS: (if different from above) __________________________________________________


PHONE NUMBER:___________________________________________________

MOBILE NUMBER___________________________________________________


* If you can supply an email address, we can email your newsletter and other information


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 ...............................................



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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