MSTCV Membership Renewal Form 2003/2004

MSTCV membership is due for renewal before July 1^st 2003. Full membership fee is $40 and associate membership fee is $20. The money is used to help run the Club and pays for the printing of the magazine, itineraries, stationery, postage, hall hire, etc. The Club is a non-profit organisation and relies on your continued support for its existence. Please complete the tear-off below and return it with your member ship fee.

Name: ……………………………………………………………………………..

Address: …………………………………………………………………………..

…………………………………………………………………………………….

Telephone: Home: ………………………………………………………………..

Work: ………………………………………….....…………………..

Mobile: ……………………………………………………………….

Email:………………………………………………………………….

Motorcycle make and model :……………………………………………………….

Do you have a medical condition that the Club should be aware of in the event of an accident?

If there is information you wish to remain confidential, please indicate.

Make cheques payable to:

Motorcycle Sports Touring Club of Victoria.

and post to:

MSTCV, PO Box 4132, Melbourne University, Parkville VIC 3052

Or Direct Deposit to:-

BSB 063 020

Account number: 10046225

and forward this form to the above address.