For Sale Section

This season is our 30th birthday!!!!

PRE 65 SALOON REGISTER (INC)

APPLICATION FOR MEMBERSHIP

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Application for Membership

			Please Tick
Full Membership	Entitles member to race	$200.00
Full Family Membership	Includes Driver, his/her spouse & siblings	$220.00
Social Membership	Entitles member to vote at AGM & to receive bulletins	$50.00
Social Family Membership	Social membership, his/her spouse & siblings	$70.00

Main Details:

Full Name
Address:
Email Address:
Home Phone:	Work Phone:
Fax Number:	Cellphone Number:
Date of Birth (for MANZ stats):

Driver Details:

Car Number:	or Requested Car Number:
Competition Licence Number:
Expiry Date:
Details & History of Car:
History of Driver:
I, hereby agree to abide by the rules & regulations of the Pre 65 Saloon Register Inc as laid down in the constitution. Ownership of a Pre 65 race car is not necessary for membership of the register
	Total Amount enclosed: $__________________
Signature of New Member:
Signature of Proposing Member:

Please return completed application & money to: Pre 65 Saloon Register, C/- Jan, PO Box 5729, Moray Place, Dunedin 9058