APPLICATION FOR BUNBURY CAR CLUB
MEMBERSHIP/RENEWAL FOR THE 2010/11 SEASON

Name:

Address:

Home Ph:

Work Ph:

Mobile:

Fax:

Email:

Occupation:

Please fill in as many fields as possible above so we can keep
you up-to-date with club news and information.

I hereby apply for membership to the Bunbury Car Club
(inc). I fully understand that I must abide by its
Constitution and by-laws. On request I will furnish the
Committee with information that will enable them to
compile a membership register.

Please choose your membership type below:

Full Voting Member:

Social Member:

Do you have any special skills that you would like to make
available to the club? For example; welding, first aid,
promotional, secretarial, plant operations, management,
truck driver etc?

By clicking the 'Submit' button below you hereby authorise the
club to use your details in conjunction with speedway business,
including receiving updates via email.