Memberships – Classic Cool Customer Car Club

Membership Renewal

If you have any question call Vicki on 0407826667 it is very important that you put the information on the form correctly and especially the information for the cars filled out correctly & returned as we have to comply with regulations and have this information on file.

Do you have a current membership number?

Please call Vicki on 0407826667 to find out your membership number before completing the payment on this form.

Membership Number

Name

First

Last Name

Last

Address

City

State/Province

Zip/Postal

Phone

Are You a Member with No Cars?

Please provide details of all cars on the Club Permit Scheme under the Classic Cool Custom Car Club

Year

Make

Model

Registration Number

Registration Expiry

Add Remove

Credit Card

Total

Terms & Conditions

I wish to renew my membership to the Classic Cool Custom Car Club Inc & remit the amount of $55.00. In doing so I once again agree to adhere to the policies and rules of the club and to Vic Roads & other State Authorities terms involving the Club Permit Scheme. Full terms and conditions can be found here

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