Application For Club Membership - Ordinary Member - Nomad
  1. Applicant Surname(*)
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  2. Applicant Title(*)
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  3. Applicant Given Names(*)
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  4. Applicant Preferred Name
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  5. Applicant Date of Birth
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    Date in Form DD/MM/YY
  6. Partner Surname
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  7. Partner Title
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  8. Partner Given Names
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  9. Partner Preferred
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  10. Partner Date of Birth
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    Date in Form DD/MM/YY
  11. Residential Address
  12. Residential Street(*)
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  13. Residential Town(*)
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  14. Residential State(*)
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  15. Residential Post Code(*)
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  16. Postal Address - only required if different from residential address
  17. Postal Street/PO Box
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  18. Postal Town
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  19. Postal State
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  20. Postal Postcode
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  21. Email Address(*)
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  22. Partner Email Address
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  23. Home Telephone
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  24. Mobile Telephone
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  25. Other Telephone
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  26. Member Directory(*)
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    Publish my details in the On-Line (Members Only) Directory
  27. Qualifying Unit
  28. Qualifying Unit Type
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  29. Qualifying Unit Make
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  30. Qualifying Unit Model
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  31. Qualifying Unit Length
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    (metres)
  32. Qualifying Unit Registration
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  33. Where did you hear?
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    Where did you hear about the Club?
  34. Member
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    Current members name or membership number if known.
  35. Other
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    Please describe the "Other" referrer.
  36. What Magazine/Newspaper?
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    Name of Magazine or Newspaper
  37. PRIVACY STATEMENT

    The ACC requires your information to assess your application and if accepted to provide you with membership opportunities and services.

    Your information will only be used for Club purposes by ACC Board members, Board appointed executives, Board approved branch office bearers or Board approved third party organisations to distribute information on the Club's behalf.

    The ACC will not release your personal data to external interests outside the Club structure for their own marketing purposes.

  38. Privacy(*)
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    to my personal information being used by the ACC as stated above.
  39. CERTIFICATION

    I agree that by clicking the Submit Application Button I am applying for membership of the Australian Caravan Club Limited and I agree that:-
    * I am applying as an ordinary members and I own (solely or jointly) a qualifying unit as detailed above and I shall advise management if I dispose of the unit and I will remove any club insignia from the unit prior to disposal.
    * I will act in a manner which is respectful of other members of the club and the community in general.
    * I will promote the best interests of the club and comply with the club constitution.
    * I am applying to join a club which is limited by guarantee and therefore if the club is wound up I may be required to contribute $5.00 toward any club debts as required by law and the club constitution.
    * My membership application shall not be approved until I have paid the application fee and membership fee.

  40. Application Payment
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  41. Total
    0.00 AUD
  42. When you click the "Submit Application" button below, you will be taken to a secure payment site where you may make your payment using "PayPal" or by using your credit card.
  43. Submit Application