P76 Car Club

Download Form

Payment by Direct Credit can be made to the Club’s
Commonwealth Bank A/c
Leyland P76 Owners Club NSW Inc.
BSB: 062 336
Account No. 1017 1082
Please email receipt to: tonkay@optusnet.com.au

Family Name:

First Name:

Family Members:

Membership No:

Home Address:

Postal Address:

Phone (Home):

Phone (Mob):

Email Address:

Please find enclosed the sum of $40.00 being full payment for membership to the Leyland P76 Owners
club of NSW for the period ending 30 June. I agree to the aims & objectives of the club & agree to abide
by the constitution & by-laws applicable to the club

Signed:

Date:

Office use:

Date Paid:

Payment Type:

Card Sent:

Membership Application/Renewal