Membership Application
Name:
*
First Name
Last Name
Address:
*
Street Address
Suburb / City
State
Postcode
Date of Birth:
*
-
Day
-
Month
Year
Date
Email:
*
Mobile Number:
*
Please enter a valid phone number.
Description of Vehicle:
Make
*
Model
*
Year
*
Rego No.
*
Details of Vehicle
*
Are you already a member of another automotive club?
*
No
Yes
How did you find out about Perth City Street Machine Club?
*
From a current member
Friend or family member
From another car club
Already knew of the Club
Dept. of Transport
W.A.S.M.A
Facebook
Internet
Other
I have been nominated by:
*
Name of Club Member
Please tell us why you would like to join Perth City Street Machine Club
*
Acknowledgement and Agreement:
*
I confirm that the above information in the membership application, is true to the best of my knowledge
I understand, and agree, that I must follow the rules of the Constitution of Perth City Street Machine Club Inc. (A copy is available at our clubroom for everyone to access and read).
I understand that I must attend the next possible monthly meeting, in person, for final membership approval and joining information
Membership costs are $100/year
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