HILLMAN CAR CLUB

OF SOUTH AUSTRALIA INC

A.B.N. 15-898-159-477

MEMBERSHIP APPLICATION

NAME:

---

ADDRESS:

---

---

CONTACT NUMBERS: Home______________________Work______________________

Mobile_____________________Email______________________

---

MODEL OF VEHICLE(S):

---

---

---

---

SUBSCRIPTION: $35.00 per annum (expires 30 June each year).

When joining, please remit either $35 for full year (1 July to 31 Dec.) or $17.50 for half year (1 Jan. to 30 June).

APPLICATIONS AND MEMBERSHIP ENQUIRIES TO:

The Treasurer (Robert Cain)

Hillman Car Club of South Australia Inc

16 Woodchester Street

Para Hills West S.A. 5096

Mobile phone 0423 819 256

e-mail to

GENERAL ENQUIRIES AND CORRESPONDENCE to be directed to:

The Secretary (Brad Flockhart)

Hillman Car Club of South Australia Inc

3 Greensfield Drive

Andrews Farm, S.A. 5114

Telephone (08) 8254 7125

e-mail to