NSW Application Form

Before you start – if you don’t have an email address you’ll have have to contact the Membership Secretary using the Print and Post form below:

The annual membership fee is $30 and the period is from 1st July to 30th June – not from the date you join!

Please use your postal address to allow delivery of your membership card and the Moto d’Epoca newsletter. If you use a Post Office Box number enter it in the “Street” field.

    First Name:

    Last Name:

    House # and street:

    City:

    State:

    Post Code:

    Home Phone:

    Work Phone:

    Mobile:

    Email Address:

    Eligible Motorcycles Currently Owned:

    (Make model year registration number)

    Contact me by email or post:

    Payment by: EFTCheque/Money Order

    On successful admission as a member to CIMAA, I agree to be bound by its rules.