Club Membership

Please fill in the details below if you would like to become a contributing member of Sydney E-Series Club.

Name

First Name

Last Name

Address

This is the address listed for the vehicle up for Registration. As listed on the NSW Registration form.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile #

(###)

###

####

Do you require Registration?

Do you require Historic or Modified Registration in NSW?

Car Specifications

Year?

What year is your E-Series?

Model?

What model is your E-Series?

Modifications?

Does the car have any modifications? If so list them here.

Registration plates? (if any)?

Provide the current Registration plates on the vehicle registered within New South Wales roads (Optional)

Payment

New Memberships $40.00 per year Please send payment to : BSB: 082342 Account number: 181646539 Name : Mr Dean Radonjic Reference: Your full name pls

Payment Sent

I would like to discuss before payment

Your Information

Please note: Submitting this form does not guarantee membership. Your application will be reviewed by our committee, and we’ll be in touch with the outcome. All information provided will remain strictly confidential and used only for the purpose of processing your membership.

I understand

If you have any questions during registration, please contact our President Dean Radonjic on 0407 991 992