CCOCA NEW MEMBER APPLICATION

Fee Details

Membership Fee is $35 for 12 months from joining anniversary date.
Membership includes soft copies of Front Drive with the option to purchase hard copies
For a Partner or a Family member, Membership is FREE.
New member applications must be approved by the CCOCA committee.
Committee meetings are held monthly on the 3rd Wednesday of the month.
No reasons are given for acceptance or refusal of new member applications.
Payment will be refunded if application is unsuccessful

Complete Form and continue to Payment

Partners or a Family member are very welcome to become members.

Applicant Name

Applicant Postal Address

Country

Applicant Contact Details:

Email

Confirmation Email

Mobile Number

MobileFormat: 0000 000 000.

A/H Phone Number

Format: (00) 0000 0000.

Partner or a Family Member Name (if applicable and wanting to become a member of CCOCA)

Contact Details if different from Applicant contact details.

Partner or Family Member E-mail

Confirmation Email

Partner or F Member Mobile

MobileFormat: 0000 000 000.

Partner or F Member A/H Ph Number

Format: (00) 0000-0000.

Applicant Occupation Past or Present

eg Accountant, Engineer, Artist, Teacher, Retired Manager

Partner or Family Member Occupation Past or Present

eg Accountant, Engineer, Artist, Teacher, Retired Manager

Applicant. Decade in which you were born.

Applicant Classic Vehicle details. eg Model,Year, Colour, Reg No.

Applicant. Are you willing to help with activities?

Yes or No or any other information

Partner or Family Member. Are you willing to help with activities?

Yes or No or any other information

How did you hear about us

eg word of mouth, car club meet, friend, bought a Citroën, website, magazine

Club’s Rules of Association Club's Privacy Policy.

I agree to be bound by the Club’s Rules of Association and I have read the Club's Privacy Policy. I understand that the Citroën Classic Owners Club of Australia Inc. accepts no responsibility for any injury to a member or guest attending an event or for any damage to personal property (including motor vehicles).

Applicant Confirm

Partner or Family Member Confirm

Select Purchase

CCOCA Membership. Includes Free Partner or Family member Membership and Soft copies of the Club Magazine Front Drive$35.00 AUD

Front Drive Hard copy (Optional Purchase)$60.00 AUD

(Click on Image to enlarge)

Total $0.00 AUD

New applications require Committee approval. New applicants will be informed of the Committee's decision. Unsuccessful applicant's monies will be refunded.

When paying PayPal gives the option of paying by PayPal or Card

CCOCA NEW MEMBERSHIP APPLICATION

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