of
Application For Membership
NAME (Last)______________________________(First)_____________________________________
SPOUSE/PARTNER SURNAME (If Different)____________________________(First Name)__________________
ADDRESS____________________________________________________________________
POSTAL CODE_________ EMAIL_________________________________________________
DATE_________________ OCCUPATION (Optional)__________________________________
TELEPHONE (Home)____________
VEHICLE MAKE (Primary English)________________________________________________________
MODEL_________________________________________________YEAR_______
MY PARTICULAR INTEREST IN THE CLUB AT THIS TIME
IS: INFORMATION_____ NEWSLETTER_____ EVENTS_____ PARTS INFORMATION_____ SOCIAL_____
WITH INITIAL APPLICATIONS PLEASE SUBMIT A PICTURE OF YOUR VEHICLES(S) FOR INCLUSION IN THE OECC REGISTRY.
NEW_____ RENEWAL_____ AMOUNT $_______
DETAILS OF OTHER ENGLISHVEHICLES
MAKE
MODEL
YEAR
Limitations on the use of personal information:
I understand that the information in the areas shown in bold type contained in
this application/renewal will be added to the Society’s membership roster
and will not be used for any commercial purpose.
If you do not want your name published in the membership roster please indicate
here [ ]
By applying for membership in the Society, I agree that I will not use other members’ personal information for any commercial purpose.
Please accept my membership
application…………………………………..
……………….
Signature
Date
Membership fees are as follows: Annual $20; after June 30th $10.00;
after October 31st 25.00 (includes following year to December 31st); all
memberships expire December 31st of each year.
Mail membership application, together with the appropriate fee, to:
CIOECC Membership Registrar,