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Join the EJ-EH Holden Club ACT

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    Vehicle Particulars (please provide photos)




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    Membership Costs and Payment

    CurrentNew Member

    New Member

    Entrance Fee (includes one Club shirt, New Member pack, and Membership to the following June):

    Single: $50Family: $55

    Family includes partner and children under 18 at same address.

    Note: As a potential new member please bring this completed form to the next Monthly Meeting for Committee approval. Meetings are held the 1st Tuesday of each month (except January) at the Canberra Deakin Football Club, 3 Grose Street, Deakin, commencing at 7:30pm. Come along at 6:30pm if you would like to have dinner beforehand.


    Require T-Shirt?

    Yes: $10No Thanks : $0

    Name for Embroidery on Club shirt:



    Current Member

    Inside Area Member’s Annual Subscription (defined by ACT Telephone Directory area):

    Single: $50Family: $55Outside Area Member: $20

    Family includes partner and children under 18 at same address

    CashDirect Debit

    Paying by cash - bring updated form to the next monthly Meeting
    Direct Debit - make payment to BSB 633 000 Account No 218 569 085 at Bendigo Bank (inc. Surname First name) and forward updated form to PO Box 208 Mawson ACT 2607 or email to [email protected]

    I agree that I have read membership terms & conditions.

    Terms & Conditions

    DOWNLOAD OFFLINE REGISTRATION FORM

    By submitting this form you confirm the following terms :

    • Your membership covers the period to 30 June of the current financial year and my membership falls due by that date each year
    • Be bound by the Club constitution/rules
    • Abide by the Concessional Registration Scheme (CRS) guidelines (if applicable)
    • Agree to release the Club from any liability arising from being engaged in any Club activity
    • Your name can be used as appropriate for Club purposes unless I specifically request otherwise.

    Note: As a potential new member please bring this completed form to the next Monthly Meeting for Committee approval. Meetings are held the 1st Tuesday of each month (except January) at the Canberra Deakin Football Club, 3 Grose Street, Deakin, commencing at 7:30pm. Come along at 6:30pm if you would like to have dinner beforehand.

    If paying by cash – bring updated form to the next monthly Meeting;

    Direct Debit – make payment to BSB 633 000 Account No. 218 569 085 at Bendigo Bank (include <Surname> <Firstname>)

    Please forward offline application form to one of following locations.

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