Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Postal Address

(if different to home address)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Acceptance of Fees and Conditions *

Following initial approval of your application by the Hillman Owners Club of Australia Inc., you will be required to pay an annual membership fee of $50 (New Members) or $45 (Renewing Members). In making this application for membership of the Hillman Owners Club of Australia Inc, I hereby agree to abide by all rules and regulations of the said club.

I accept

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Acceptance of Rules of HOCA Inc. *

I hereby agree to abide by the Rules of HOCA Inc. I understand that should I not pay my membership renewal fee within 3 months of the due date, the HOCA rules provide that my membership has lapsed.

I agree

Acceptance of Fee and Payment conditions *

I agree to transfer the membership renewal fee of $45.00 to the club's account, or to make arrangements for payment with the Treasurer or Secretary by the due date of 30th June 2019. If making a direct deposit, I agree to include my name in the reference field to ensure efficient processing. I understand that if my payment is not received by the due date mentioned above, my membership will lapse.

I agree