Join the Club!
APPLICATION FOR MEMBERSHIP / RENEWAL OF MEMBERSHIP
Note that you get a sticker kit and membership card with your membership.
SURNAME: ___________________________________ |
FIRST NAMES: ___________________________________ |
I.D. NUMBER ___________________________________ |
HOME ADDRESS:_______________________________________________________________ |
| _________________________________________________CODE:______________________ |
POSTAL ADDRESS:_____________________________________________________________ |
| _________________________________________________CODE:______________________ |
| PHONE: (W)_________________(H)__________________(CELL)___________________ |
| E-MAIL ADDRESS: _____________________________________ |
| OCCUPATION:__________________________COMPANY:_______________________________ |
| HOBBIES AND INTERESTS:_______________________________________________________ |
| INTRODUCED BY:______________________________________________________________ |
| CAR:_________________________YEAR:______________REG
#:_______________________ |
I, the undersigned, agree to abide
by the rules, regulations and constitution of the Club. I
further agree that all events organised by the Toyota Twin
Cam Club in which I participate or spec Tate shall be entirely
at my own risk, and I indemnify the employees, committee and
members of the club from any claim for loss, damage, loss
of life or any other matter arising, whatsoever.
I hereby wish to join the Toyota
Twin Cam Club and submit my membership fee of: R 350.00 for
2010.
DATE:___________________________________
SIGNATURE__________________________
MEMBERSHIP NUMBER_________________
Please address all correspondence
to the address below. (cheques can be made payable
to: TOYOTA TWIN CAM CLUB - please fax a copy of the deposit
slip)
Address:
Post net Suite 223
Private bag x26
Sunning Hill
2157
Tel: 0833264374 - Thags Govender or
0834685242 - Tony Lala
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Banking Details
Account Name: Toyota Twin Cam Club
Bank: Nedbank Bramley
Branch Code: 196605
Account Number: 1966379986
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