VETERAN VINTAGE AND CLASSIC MOTOR CYCLE CLUB ACT INC.

(incorporated under the Associations Incorporation Act 1991)

RENEWAL OF MEMBERSHIP FORM

(for use only with renewing by email and payment of fees by direct deposit or Internet banking)

On completion of this form, please email it to


(full name of primary riding member – see Note) /
MEMBERSHIP NUMBER

(date of birth of primary riding member) / Acknowledgement:
Members' names that appear in this e-form acknowledge that they have read and understood the Club Rules (available to view on VVCMCC web site via the ‘About the Club’ link in the main menu) and, for the term of the membership period shown below, acknowledge that the Club and those bodies with which the Club is affiliated, have no responsibilities for any damage or theft of machinery or possessions or any bodily injury sustained during the course of participating in Club events. Disagreement to these conditions may result in the renewal for membership being rejected.
Please note agreement/disagreement by crossing out that which is not applicable.


(preferred or introduction name - primary riding member)

Spouse/partner’s preferred name)

(full name of family/additional riding member – see Note)

(preferred/introductory name family/ additional riding member)
POSTAL ADDRESS

(No and Street Name) / Note on Membership: A single full or senior membership covers membership for one member (primary riding member) and partner living at the same address. An additional fee of $5 applies for Family Membership (includes additional riding member), which entitles the partner to have the privileges of a full member in respect of voting on Club issues, access to the Concessional Registration Scheme for veteran, vintage or historical motorcycle/vehicle, and family attendance at Club subsided functions.

(suburb)

(State)

(Post Code)

(E-mail)
PLEASE ENSURE DETAILS OF CRS PLATED MACHINES/VEHICLES ARE LISTED IN THE TABLE AT THE BOTTOM OF THIS FORM

MEMBERSHIP FEES

CATEGORY / 1 MAY - 20 APRIL / Amount Paid
Late Fee (applies from 1 August) / $5
Full (Riding) Member (see Note on Membership) / $30
Senior (Riding) member (see Note on Membership) / $20
Family/Additional Riding Membership / $5/nominee
NOTE: Please include bank transaction details in the email to the treasurer so that payment can be reconciled. / TOTAL
VETERAN VINTAGE AND CLASSIC MOTOR CYCLE CLUB ACT INC. / MEMBERS NAME
MEMBERS CONCESSIONAL REGISTRATION SCHEME (CRS) ‘V’ PLATED AND ‘H’/’G’ PLATED MACHINES
V or H/G Rego Number / Year / Machine Make / Model / Colour Scheme
1
2
3
4
5
6
7
8
9
10
11
12
13
14

If you have more than 14 machines/vehicles to list, please copy and paste the table into the next page and update numbers in the left hand column as needed.

(THIS SECTION FOR USE OF CLUB OFFICIALS ONLY)

RECEIPT NUMBER / MEMBERSHIP NUMBER
RECEIPT DATE / MEMBERSHIP LIST UPDATED
AMOUNT PAID / MEMBERSHIP CARD ISSUED