DUCATI OWNERS CLUB OF W.A.
APPLICATION FOR MEMBERSHIP
PO BOX 351 Victoria Park 6979
| Name: | |
| Address: | |
| Postcode: | |
| Phone: (Home) | |
| (Work) | |
| (Mobile) | |
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| Motor Cycle: |
| New Member: $65 | ||
| Renewal: $60 |
| Membership Number (if known) |
I hereby make application for membership to the Ducati Owners Club of W.A.
and agree to abide by its rules and constitution.
Signature: ____________________________.
Date:
OFFICE USE ONLY
| Treasurers Records | ||
| Mailing List | ||
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| Paid |