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Application for Membership of the Overlander 4WD Club Inc

Incorporated under the Associations Incorporation Act 1984.

I hereby apply to become a member of the above-named incorporated association. In the event of my admission as a member, I agree to be bound by the rules of the association for the time being in force.

Membership is $55 for the first year, and $45 per year afterwards. Note that only Family membership is now offered, in order to promote the family-friendly nature of the Club.

If you wish to join the Club, please complete the following form.

Full Name:
Spouse's Full Name:
Home Address:
Postal Address:
Email address:
Phone (Home): (eg: 02 12345678)
Phone (Mobile): (eg: 0400 000000)
Occupation:
Type of Membership: * NB: Family Membership is now only offered
   
Vehicle Details  
Manufacturer: (eg: Toyota/ Nissan)
Model: (eg: Landrcruiser/ Patrol)
Vehicle Series: (eg: 100 Series/ GU)
Vehicle type: (eg: Wagon/Dual Cab)
Year: (eg: 2007)
Colour:
Transmission:
Fuel:
Registration Number: (eg: AAA111)
State: