CCOCA NEW MEMBER APPLICATION

CCOCA NEW MEMBERSHIP APPLICATION

Credit Card or PayPal
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
- Partner or a Family member, Membership is FREE.
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
1920 - 19291930 - 19391940 - 19491950 - 19591960 - 19691970 - 19791980 - 19891990 - 19992000 - 20092010 - 2019
Applicant 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).
Confirm being bound by Club's Rules of Association and reading Club's Privacy Policy
Confirm being bound by Club's Rules of Association and reading Club's Privacy Policy
Select Purchase*
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CCOCA Membership. Includes Free Partner or Family member Membership and Soft copies of the Club Magazine Front Drive$35.00AUD

Front Drive Hard copy (Optional Purchase)$45.00AUD
(Click on Image to enlarge)

Total $0.00AUD
New applications require Committee approval. New applicants will be informed of the Committee's decision. Unsuccessful applicant's monies will be refunded.
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CCOCA NEW MEMBERSHIP APPLICATION