• Info & Contacts:
Spare parts etc
• Regular activities:
Picnics, trips etc
• Club Newsletter
• Qterly National Mag: • Annual Events:
"New Zealand Citroen"
Gymkhana
Pride of
Ownership
National Rally
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Join today by printing and posting application form with remittance to: The Secretary Annual subscription rate is $38-00 |
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To print(Explorer users: highlight form * file menu * print * selection * OK)
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MEMBERSHIP APPLICATION FORM - Taranaki West Coast Citroën Car Club |
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I/We wish to apply to be elected as member/s of the Taranaki West Coast Citroën Car Club (Inc) and agree to abide by the Club rules. I/we consent to the information contained on this form being used in any way in connection with the objects of this Club, (or the CCCNZ, to which it is affiliated) I/we acknowledge my/our right of access to, and correction of this information. This consent is given in accordance with the Privacy Act 1993. |
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Names |
First Name |
Last Name/Surname |
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Name |
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Partner/Spouse |
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Dependants/Others |
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Address Street: |
Residential |
Postal: (if different from residential) |
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Suburb: |
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City/Town: |
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Occupation: (requirement of Incorporated Society Act) |
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Details of Citroën/s Owned |
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Model type |
Year |
Registration |
Colour |
km/mls |
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Phone : (home) |
(work) |
(email) |
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Applicant Signature: Date: |
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