New Membership Application

MG CAR CLUB CANBERRA Inc.

PO Box 4141, Weston Creek, ACT, 2611 Australia
New Member Application

I hereby apply to become a member of the MG Car Club Canberra Inc. and agree to abide by the Constitution, By-laws and Policies of the Club (available here).
Privacy Statement

We will only use your personal information for the purpose for which it was provided to us, for related purposes such as fulfilling our role in the ACT’s Concessional Registration Scheme, or as required or permitted by law.
Personal Details
Applicant Name*

TitleFirst NameLast Name
Applicant Preferred First Name
Address*

Street Address

Street Address Line 2

CityState

Postcode
Preferred Phone Contact

Area Code (Landline Only)Phone Number
Alternate Phone Contact

Area Code (Landline Only)Phone Number
Preferred Email Contact*

Confirmation EmailEnter twice for confirmation
Alternate Email Contact

Confirmation EmailEnter twice for confirmation
Please enter your age bracket (to assist with Club planning)

Membership Categories and Fees
Please Select Your Membership Category*

Single - $70 pa. Full membership for one individual.Family - $80 pa. Full membership for primary member, spouse/partner and dependent children under the age of 18.Associate - $50 pa. Limited membership for non-MG owning member wishing to participate in only some Club activities (eg motorkhanas), ineligible to vote or use Club sponsored Concessional Registration.
Are you applying for a new membership after 31 December 2024? (pay half the relevant membership category fee)*

YesNo
Carbon Offset Contribution

Club Management Policy No. 1 provides for members to make a voluntary contribution to carbon off-set for their Club motoring activities. The calculated carbon offset amount is $5 per Club car.

All monies collected for carbon offset are directed to our carbon offset partner Greenfleet https://www.greenfleet.com.au/.
Would you like to make a voluntary carbon off-set contribution?

YesNo
Please enter the carbon off-set amount $*

Your Car Details
Primary car details.
Would you like to record additional MG / Historic / Vintage Car Details?

YesNo
Additional Family Member Details

(for Family Membership)
Partner Name

TitleFirst NameLast Name
Partner Preferred First Name
Would you like to record other family member details for Family Membership?

YesNo
Other Family Member Details

First NameLast Name
Other Family Member Details

First NameLast Name
Other Family Member Details

First NameLast Name
Other Family Member Details

First NameLast Name

Fee Summary and Submission
Your Membership Fee is: $
Your Carbon Offset is: $
Your Total Membership is: $
Please review your form prior to submission. You will be able to print your application prior to submission and will recieve an acknowledgement email following your submission.

Your completed form will be sent to the MGCC Canberra Membership Secretary who will contact you to advise acceptance of your application and arrange payment of the membership fees.

By submitting this form you are deemed to have signed and dated the application for membership.
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MG CAR CLUB CANBERRA Inc.