NEW ZEALAND ROLLS-ROYCE AND BENTLEY CLUB INC
APPLICATION FOR MEMBERSHIP
Please PRINT details, retain a copy, and post to the Membership Registrar:
Rob Carthew, 85a Wharewaka Rd, Taupo, 3330, New Zealand.
Phone: 07 377 4117 Mobile: 0274 974 264 Email: watcher@pl.net
MEMBERSHIP
Prime Member
(as you wish to appear on the name-tag)
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Family Members
(names of additional members,
for name-tags)
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Postal
Address
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Post
code
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Occupation
of Prime Member
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Telephone:
Private
Business
Mobile
Facsimile
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E-mail
address
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$75
$
$10
$
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SUBSCRIPTION
Annual Fee:
Prime Member $75
Family Members (each) $5
Application fee (once only) $10
Remittance enclosed payable to
NZ Rolls-Royce & Bentley Club Inc.
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VEHICLES
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At
present, I own the following
Rolls-Royce/Bentley car(s):
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Please
continue on a separate sheet if
necessary
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Make
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Model
& year
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Body
style/coach-builder
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Registration
number
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Chassis
number
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SIGNATURE
AND DATE
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Signed and
dated
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If elected
to membership of the New Zealand
Rolls-Royce and Bentley Club Inc, I agree
to abide by the Rules of the
Club.
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INFORMATION RELEASE PRIVACY ACT 1993
Under this Act, we must
advise that names and addresses of members,
along with the abbreviated details of their
Rolls-Royce and Bentley vehicles, may be
published from time to time in a confidential
membership list for the information of other
members, and payment of an annual subscription
acknowledges this.__
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