JDCC - Membership Application / Renewal Form 2007/2008

I hereby apply to be a member/renew my membership of the Jaguar Drivers' Club of
Canberra Inc. and agree to abide by the rules of the Club.

   Applicant's Surname     Initials 

     Preferred Given Name  

   Partner's Surname (Optional)     Initials 

     Preferred Given Name  

   Address details For Correspondence   

      City/Town         State    Postcode 

   Residential Address (if different)         

     City/Town          State    Postcode  

     Telephone (H)    (W)    Mobile 

     Email     Current Member No. 

CAR INFORMATION

   Model    Body Style    Colour 

     Year    Engine Capacity    Rego No. 

   Model    Body Style    Colour 

     Year    Engine Capacity    Rego No. 

FEES  The membership year is a financial year (from July to June).

Membership (includes dependents) $60 pa  
     Half year (if joining after December)    $30  
     Quarter year (if joining after March)    $20  
Signed Date       /      / $

To submit your membership application / renewal please complete this form, print, sign and
date it and forward it with a cheque for payment of fees to:
Jaguar Drivers' Club of Canberra Inc.  PO Box 4400.  KINGSTON   ACT  2604