New HVMC Membership

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

New HVMC Membership

Enter details.

Last Name *

First Name *

Address 1 *

Address 2

Address 3

Phone (Home)

Phone (Work)

Mobile

Email Address *

D.O.B. *

YYYY

Nominated By

Seconded By

Make and model of car(s) if any

Details of competitive motoring/other clubs

Any experience on club committees or in organizing

I wish to apply for membership of the Hutt Valley Motorsport Club (Inc.) and it accepted, i agree to abide by the rules of the club. I have never been refused membership by, or been expelled from any other club affiliated to Motorsport NZ (Inc.). Consent under the Privacy Act 1993. I consent to HVMC (Inc.) collecting the details provided on this application, retaining and using details for the purpose of HVMC(Inc.) and Motorsport NZ(Inc.) information. I acknowledge my right to have access to this information. This consent is given in accordance with the Privacy Act 1993. *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Camshaft Software. Report Abuse

Forms