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 To become a member HEAVEN VMX Inc, please print out, fill in, sign and post the form to the address below:


APPLICATION FOR MEMBERSHIP OF HEAVEN VMX INC.
incorporated under the Associations Incorporation Act 1984

First Name:



 Family Name:



 


Street:

Suburb:

State:

Postcode:

Home Phone:

Mobile Phone:

Work Phone:

email:
   

Birth Date:

MNSW Lic. No:

Job:

Other interests:



   
Please list the type of bikes you own, and your preferred Racing Number:
   
Preferred
 
Bike Brand
Model
Capacity
Year
Race No
Class




































   
I hereby apply to become a member of HEAVEN VMX Inc. and agree to be bound by the rules of the association.
Signature:




Date:

Membership fees:

Senior membership fees are $30.00 per annum. A discount of $5.00 will apply to recieve Club News
on the website: www.heaven-vmx.com/news.htm
If you wish to recieve a paper newsletter, membership fees will be at $30.00 per annum

Family membership fees are $40.00 per family - including children under 18 years

Please tick a box to indicate your preference:

  Senior Membership - Internet Newsletter
$25.00
  Senior Membership - Paper Newsletter
$30.00
  Family Membership
$40.00

Please make the payment payable to "HEAVEN VMX Inc."

Mail to:

The Secretary
HEAVEN VMX Inc.
GPO Box 794
Sydney NSW 2001

Thank you for becoming a member of HEAVEN VMX Inc, we hope you enjoy the club - welcome!