APPLICATION FOR MEMBERSHIP 2024

APPLICATION FOR MEMBERSHIP 2024
SURNAME*
GIVEN NAMES*
ADDRESS*

Street Address

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PHONE (HOME)*

Area CodePhone Number
PHONE (MOBILE)

Area CodePhone Number
DATE OF BIRTH*

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EMAIL ADDRESS*
example@example.com
I hereby apply for general membership of the Hyundai Excel Racing Association of Australia (Victoria Incorporated) and agree to abide by the regulations, Rules and By-Laws of the Association, the Hyundai Excel Racing Victoria Technical Regulations and the Motorsport Australia Manual of Motorsport, and support the spirit and objectives of Hyundai Excel Racing Victoria. I certify that the above particulars are true and correct.
Do you agree to the above?*

Yes, I agreeNo, I do not agree
FEES: All fees are from January 1st. to December 31st.

GENERAL MEMBERSHIP – $100.00

SOCIAL MEMBERSHIP - $40.00

Please attach cheque / money order (not cash if by post) and make payable to Hyundai Excel Racing Association Victoria Inc. Please return this form with payment.
Please check this box if you do not wish to receive advertisements from our club sponsors

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Internet Payment: Commonwealth Bank Account Name: Hyundai Excel Racing Association Vic. Inc.

BSB: 063549 Account No: 10663717

In reference field please put your surname.
CHOOSE YOUR MEMBERSHIP*

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MEMBERSHIP NUMBER
RACE CAR NUMBER
LOG BOOK NUMBER
CAMS LICENSE NUMBER
Post to: Membership Secretary

Hyundai Excel Racing Association Vic. Inc.

61 Buchanan Road

BERWICK Vic. 3806
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