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VMCi Membership Application & Renewal Form
Membership Type
Please note that credit card payments will incur a $3 surcharge.
Adult - $90
Couples - $95
Family - $100
Junior - $50
Are you renewing a membership
Please choose yes if you are currently, or have previously been a VMCi Member
Yes
No
Membership Number
If you have previously been a member of the VMCi, or are renewing your current membership, please provide your membership number.
MAIN APPLICANT DETAILS
First Name
Last Name
Date of Birth
Note: To change the year on the pop up calendar, tap on the month name.
DD
/
MM
/
YYYY
Email
Phone Number
Occupation
Mailing Address
Enter your mailing address for correspondence and for the monthly MiniMag magazine
PARTNER'S DETAILS
Partners Name
Partner's Membership Number
Required for renewals only
Partner's Date of Birth
Please provide your Date of Birth
DD
/
MM
/
YYYY
Partner's Email
Partner's Phone Number
CHILDREN'S DETAILS
Please enter full name (first and last), Date of Birth (dd/mm/yyyy), and previous membership number (if renewing) for each child.
PLEASE NOTE: Children must be under 18 years to be eligible for inclusion in a family membership.
Child 1 Name
Child 1 Member No.
Child 1 DOB
DD
/
MM
/
YYYY
Child 2 Name
Child 2 Member No.
Child 2 DOB
DD
/
MM
/
YYYY
Child 3 Name
Child 3 Member No.
Child 3 DOB
DD
/
MM
/
YYYY
Child 4 Name
Child 4 Member No.
Child 4 DOB
DD
/
MM
/
YYYY
OTHER DETAILS
Are you a candidate for or holder of a CPS vehicle?
Is your car currently operating under the Club Permit Scheme, or are you intending to move your car to the VMCi's CPS?
Yes
No
Type of Car
If you answered yes, what kind of car do you want to put on the CPS? (Please list Make, Model & Year)
MiniMag Delivery
Please choose your preferred method for receiving MiniMag each month. Digital eMag is supplied in full colour - Hard copy is printed in black & white.
Digital eMag via email (Colour)
Hard Copy via post (Black & White)
I don't want to receive MiniMag
Club Constitution Agreement
I/We agree to be bound by the
constitution of the Victorian Mini Club Incorporated (Reg A0027607A)
Pay online with credit card via Paypal? (does not require a Paypal account)
If you choose this option, you'll be redirected after you hit the submit button to the PayPal website where you can use a credit or debit card to pay your membership dues. Payment does not require a PayPal account.
Yes
No
Verification
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