Membership Application

Name *

First

Last

Street Address *

Suburb *

Postcode *

Phone *

Email *

Date of Birth (dd/mm/yyyy) *

Membership category *

Commonwealth Pensioner Concession Card Number

Please enter if you are applying for Pensioner membership

I am currently a member of a MAAA Affiliated Club and am applying for Associate membership of HMAC *

Current MAAA Affiliated Club Membership

Enter the name of the Club if you answered Yes to the question above

I have previously been a member of a MAAA Affiliated Club *

Previous MAAA Affiliated Club Membership

Enter the name of the Club if you answered Yes to the question above

Acceptance of Conditions *

I hereby agree to abide by the Club, State and Federal Associations rules and regulations

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