CHRISTIAN AUTOSPORTS CLUB OF AUSTRALIA Incorporated

PO BOX 49 RED HILL QLD 4059 (Incorporated under the Associations Incorporation Act of 1984.)

Membership Application

 

Member/s Full Name/s

 

 

 

Address

  

Suburb

  

Post Code

 

Phone No/s

(Home)

  (Work)

(Mobile)

Email Address/es

(Home)

 (Work)

 

 

 

 

 

 

 

 I/we hereby apply for new membership of the abovementioned association. In the event of my/our admission as member/s, I/we have read the constitution and agree to be bound by the rules of the association for the time being in force.

Member's Signature

 

Date

 

Member's Signature

 

Date

 

Member's Signature

 

Date

 

Notes: · If any members are under 18 years old, his/her legal guardian must also sign.

Family membership includes two adults plus any junior members.

· If more than 3 members include details for other on a separate sheet.

Declaration by a Minister of Religion.

Minister to complete:

 

I . . . . . . . . . . . . . . . . . . . . . . . . . …….. . . . . . . . . (minister) recommend the above signed person(s) as eligible for membership.

Signature of Minister .

Date ……/……/…….

Applicant(s) please complete the following information:

Name of church attended

  

Minister's Name

  

Other club affiliations

  

  

Member 1

Member 2

Member 3

Date of birth 

 

 

 

When did you become a Christian? 

 

 

 

Do you hold a current driver's license?

(Yes/No)

(Yes/No)

(Yes/No)

 Provisional?

(Yes/No)

(Yes/No)

(Yes/No)

Make/Model of Vehicle(s)

Brief details of other modifications 

 

 

 

 

 

 

Club Fees: Single - $38 Family - $65 Junior - $30

Total Paid

$

Receipt Number

Licenses Posted (Yes/No)

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