Leyland P76 Owners Club Of Victoria

Membership Application and Renewal Form : 2008-2009

Please make your cheque etc of $60.00 payable to

"Leyland P76 Owners Club Of Victoria"

and mail to "The P76 Registrar"

c/o 245 Windemere rd Lara 3212

 
SURNAME:_____________________________________________
 
GIVEN NAMES:_____________________________________________
 
ADDRESS:_____________________________________________
 
_____________________________________________
 

POSTCODE:______________

 
PHONE NO:_____________________________________________
 
EMAIL ADDRESS:_____________________________________________
 

if you wish to join or continue your membership PLEASE COMPLETE AND SIGN THE APPLICATION FORM

I............................................. AGREE TO ABIDE BY THE RULES OF THE LEYLAND P76 OWNERS CLUB OF VICTORIA INC AND WORK TOWARDS THE FULFILLMENT OF THE OBJECTIVES OF THE CLUB.
 
SIGNED:................................................. DATE............................

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