Nomination for Membership

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Nomination for Membership

First Name:

Last Name:

Email:

Phone:

Address:

Suburb:

Town:

Please nominate me as a Member of (Please indicate ONE Club)

Manawatu RC

Marton JC

Feilding JC

Rangitikei RC

Type of Membership (Please indicate ONE)

	$175 PREMIER Membership
	$100 RACE "full" Membership
	$40 Country Club Member
	$30 Single Country Club Member
	$30 Manawatu "Under 30" Member
	Date of birth required for U/30 Membership

Note: on receipt of your enquiry an invoice and Membership application (to be signed) will be forwarded to you directly.

For more information contact:
Brent Wall Membership Manager
brent@manawaturacing.co.nz