Membership Renewal Form

For existing members, renewing for another year.

Due by June 30th each year.

Bank Details for the ETF transfer will be shown after you submit the form.

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Membership Category (Required) *

• Single Membership ($87)
• Dual/Family Membership ($97)
• Silver Membership Renewal ($57)

Member Details *

First

Last

First and last name of the Primary Member

Email Address *

Email Address completed

Mobile Phone Number *

Have Any Details Changed?

Please update any information that has changed since your last renewal. E.g: Address, Vehicle Make, Vehicle Model, Registration Number, Vehicle Colour, Fuel Type

Do you have a current First Aid Certificate?

• Yes
• No

Do you have a Chainsaw Accreditation?

• Yes
• No

Have you completed 4WD Driver Training?

• Yes
• No

E.g. a 4WD proficiency course

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Relationship *

Membership Declaration *

• I agree to the below (required)

I confirm that the information provided is correct and I agree to continue abiding by the Rules, Policies (including the Privacy Policy) and conditions of membership of the Victorian Four Wheel Drive Club Inc.

EFT Reference Used (Required)

Please enter the name/reference you will use when making your EFT payment (Surname preferred). NOTE: Bank details to make EFT payment will appear once you submit the form.

Submit

NB: Submitted forms will go straight to the Club Treasurer – no need to email them separately.