Member Details
Membership No:
Surname:
First Name:
Family Members:
(if applicable)
Address:
Suburb/State: / Postcode:
Phone Home: / Work:
Mob. / Email:
Industry/Occupation
Your Primary MG [if more than one owned, list on page 2]
Model: / TC / TD / TF
MGA Roadster / MGA Coupe / MGB Roadster / MGB GT
MGB GTV8 / MGC Roadster / MGC GT / MIDGET
Post War Classic Sedans: / YA YB YT / ZA Magnette / ZB Magnette
MKIV Magnette / MKV Magnette / MG 1100 / MG 1300
Modern Sports Models: / RV8 / MGF / MGTF
Other Model: (if not listed)
Year: / Reg No. / Colour:
Chassis No. / Engine No;
Conc Lic.? Y/N
About You
Areas of Interest: / Social Competition Concessional Licensing
Insurance Technical Library
Other:
Age Range: (optional) / 20-30 30-40 40-50 50-60 60-70 70+
Type of Membership
Member $90 (Owner, spouse/partner & if applicable children <21)
Pensioner $70 (Owner, spouse/partner & if applicable children<21)
Pension Card No. (if Pensioner)
Payment Option: By EFT By Mail (see over page) / Total Paid: $
Signature: / Date:

How to Pay:

·  Cheque or Postal Notes:
Payable to The MG Car Club of Western Australia (Inc.)

Post with your completed application form to the Club’s postal address:
GPO Box U1924, PERTH WA 6845

Electronic Funds Transfer:
Commonwealth Bank, Inglewood WA

BSB No. 066111 Account No. 1002 5340

Transaction to read – your surname and initial, Renew

(e.g. SmithB Renew)

Email your completed application form to

Other Information:

Note: All Memberships are based on the Calendar Year, expiring December 31st.

(Except one-day Special Event Membership)

Privacy Notice: Please note that your personal information will be treated as confidential in accordance with Commonwealth privacy legislation and will only be used for purposes associated with the administration of the Club. Your details will not be released to any third parties for any commercial purpose. However, under Section27 of the Associations Incorporations Act 1987, your name and address (only) must be made available to another member of the club on request.

Club news and information: can be found at the Club’s website www.mgccwa.com

Club General Meetings: 3rd Tuesday of each month (fellowship 7:30pm, meeting 8:00 pm)

Octagon Magazine: The hyperlink for the monthly Octagon magazine will be emailed to your email address – please ensure that this is correct. If no email address is provided, a hardcopy will be posted to your nominated address.

Other MG Vehicles Owned
Post War Classic Sports Models: / TC / TD / TF
MGA Roadster / MGA Coupe / MGB Roadster / MGB GT
MGB GTV8 / MGC Roadster / MGC GT / MIDGET
Post War Classic Sedans: / YA YB YT / ZA Magnette / ZB Magnette
MKIV Magnette / MKV Magnette / MG 1100 / MG 1300
Modern Sports Models: / RV8 / MGF / MGTF
Other Model: (if not listed)
Year: / Reg No. / Colour:
Chassis No. / History (Prev owner etc):