SURNAME GIVEN NAMES DATE OF BIRTH ADDRESS TELEPHONE OCCUPATION APPLICATION DATE EMAIL	:......................................................................... :......................................................................... :........................./.........................20.................. :......................................................................... .......................................................................... POST CODE :................................................. (H) :.................................................................. (W) :................................................................. :......................................................................... :........................../.........................20................. :.........................................................................
			SIGNATURE ............................

MEMBERSHIP FEES

JOINING FEE : $ 10.00

MEMBERSHIP FEE : $ 25.00 Per person per financial year.

Meetings are to be held tri-monthly, with notification listed in The Advertiser Club Notes on Thursdays.

The elected Committee reserves the right to deny membership to the Club and will return membership fees in full as per the constitution.

Please post application form together with cheque to:

PLEASE LIST DETAILS OF THE FIATS YOU DRIVE