Membership Application Form

HELP PRESERVE OUR TRANSPORT AND TECHNICAL HERITAGE AND SUPPORT MOTAT
Membership Application Form

Annual membership runs for 12 months from date of payment for General Members or from date of application for Volunteers & MOTAT Staff.
As a MOTAT Society member you will receive the following benefits:
- The Society’s quarterly newsletter – The Squeaky Wheel;
- The Society’s monthly Events and Announcements updates;
- Free venue entry and coach travel to MOTAT Society excursions;
- A 10% discount at the MOTAT shop;
- 10% off a MOTAT Mates Annual pass which you can use or give as a present;
- One free transferable day pass annually to MOTAT for 2 adults and children under 15.
MEMBERSHIP CATEGORY*

Volunteer (Free)MOTAT Staff (Free)General Individual $35pa
If MOTAT Staff please state Job Title.
Name*

PrefixFirst NameLast Name
Salutation*
What would you like to be called?
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home phone
Work phone
Mobile

Area CodePhone Number
Permissions*

I am happy to receive Society notices and events by email.I am happy to receive my Squeaky Wheel by email.I agree to the Society Rules (available on Contacts page of our website)
Signature

Clear
Payment for membership or donations can be made over the counter bank deposit or online banking to the account of The MOTAT Society, ASB Bank 12-3011-0755920-00 using your name and "newmem" as references. NB: The ASB Bank no longer accepts deposited cheques, please do not send membership fees or donations in the form of cheques.
Payment

$35.00 General Membership FeeDate Payment Made:
Should be Empty: