Membership Application Form




MEMBERSHIP 2013/14
Full Members $249 | Full Members (18-30 y.o) $150

Member benefits include admission and Members’ Reserve access for all MVRC meetings, free racebook and beverage at each meeting you attend and much more.

*MVRC can assist applicants with a proposer and seconder when applying for MVRC Membership.
*Members purchasing a Young Membership (18-30yrs) will need to supply proof of birth date.
*18-30 Years, proof of age must be supplied via membership@mvrc.net.au
Title
First Name
Last Name
Date Of Birth (DD/MM/YY)
Email address
Postal Address
Suburb
State
Postcode
Country
Telephone (H)
Telephone (W)
Mobile
Employment Industry
Position Held
Other Club Memberships
Proposer (*MVRC can assist)
Seconder (*MVRC can assist)
Membership Type (DOB will need to be verified)

Annual Guest Card (optional) - $220

Payment Details



Credit Card Number
Expiry Date (MM/YY)
CCV / Security Code
Cardholders Name
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