VCBG Membership Registration/Renewal Form

This is a NEW membership
I am renewing an existing membership
I am UPDATING information only.

The Email address is NOT stored on the site but is stored offsite in the Contacts Database. Providing an Email address allows us a convenient method of keeping you up to date with coming events and important group activities. Although it is rare not all members may have an Email address. If this is the case please make sure you leave other valid contact details.

    Please <TAB> through this Registration Form

First Name: Surname:
Contact Email Address:
NOTE: Email address is NOT stored on site anywhere. Avoids spam robots.
Postal Street Address:
City: State: Post Code:
Contact Phone No:   Mobile No:
I am happy to have my phone number listed in the Members Only Contact area
  on this web site (password req to access):
Oz Clubbies Forum ID: Yahoo Forum ID:

$25 Membership: Use 1 of the 3 Payment Methods listed below:

1.You may submit this form by pressing the "SUBMIT" button below. You will then need to transfer the
    payment to the Victorian Clubman Builders Group A/C at Bendigo Bank
                 BSB = 633-000
                Account = 122446974

   DETAILS = In order to Identify your payment please enter 'MS'plus the
        Contact Phone number you used above. Enter this information in the
        'DETAILS' section of your direct debit transfer. eg. 'MS 98795022'

or
2. Print this form and post the Form together with a Cheque/Money Order
    TO: Brian Adlam, PO Box 234, Gembrook - Vic - 3783

or
3. Pay your membership fee at any Group Meeting direct to Brian Adlam.

I will pay by Electronic Funds Transfer
I will Mail this form together with a Cheque or Money Order
I will pay at the next group meeting
I am UPDATING information only.

To Print this form go to <File> on the Browser Menu and then choose <Print>.