{"id":286,"date":"2011-10-05T09:39:50","date_gmt":"2011-10-04T22:39:50","guid":{"rendered":"http:\/\/www.cimaa.asn.au\/?p=884"},"modified":"2025-05-23T02:45:31","modified_gmt":"2025-05-23T02:45:31","slug":"victorian-application-form","status":"publish","type":"page","link":"https:\/\/cimaa.asn.au\/index.php\/victorian-application-form\/","title":{"rendered":"Victorian Application Form"},"content":{"rendered":"<p><span style=\"color: #ff0000;\">It is 2025&nbsp; &#8211; we no longer accept Cheques or Money Orders or Cash payments &#8211; EFT only!<\/span><\/p>\n<p>If that is not possible, or if you <strong>don&#8217;t have an email address<\/strong> you&#8217;ll have have to contact the Membership Secretary using the <em>Print and Post<\/em> form below:<\/p>\n<p><a href=\"http:\/\/www.cimaa.asn.au\/vicapp.pdf\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-645 aligncenter\" title=\"print_form\" src=\"http:\/\/www.cimaa.asn.au\/wp-content\/uploads\/2011\/10\/print_form.gif\" alt=\"\" width=\"83\" height=\"24\"><\/a><\/p>\n<p><strong>The annual membership fee is $30 and <\/strong><strong>the period is from 1st July to 30th June &#8211; <em>not from the date you join!<\/em><\/strong><\/p>\n<p><em>Please use your postal address to allow delivery of the Membership Card. If you use a Post Office Box number enter it in the &#8220;Street&#8221; field.<\/em><\/p>\n<p>\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f543-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"543\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/286#wpcf7-f543-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"543\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.2\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f543-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p>First Name:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"firstname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"firstname\" \/><\/span><br \/>\nLast Name:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lastname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lastname\" \/><\/span>\n<\/p>\n<p>House # and street:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"street\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"street\" \/><\/span>\n<\/p>\n<p>City:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n<\/p>\n<p>State: <span class=\"wpcf7-form-control-wrap\" data-name=\"state\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"state\"><option value=\"Vic\">Vic<\/option><option value=\"Tas\">Tas<\/option><option value=\"SA\">SA<\/option><option value=\"WA\">WA<\/option><\/select><\/span>\n<\/p>\n<p>Post Code:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"postcode\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"postcode\" \/><\/span>\n<\/p>\n<p>Home Phone:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"homephone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"homephone\" \/><\/span>\n<\/p>\n<p>Work Phone:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"workphone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"workphone\" \/><\/span>\n<\/p>\n<p>Mobile:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"mobile\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mobile\" \/><\/span>\n<\/p>\n<p>Email Address:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n<\/p>\n<p>Eligible Motorcycles Currently Owned:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"motorcycles\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"motorcycles\"><\/textarea><\/span>\n<\/p>\n<p> (Make model year registration number)\n<\/p>\n<p>Contact me by email or post: <span class=\"wpcf7-form-control-wrap\" data-name=\"contactmode\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"contactmode\"><option value=\"Email\">Email<\/option><option value=\"Post\">Post<\/option><\/select><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"terms\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"terms\" value=\"1\" checked=\"checked\" aria-invalid=\"false\" \/><\/span><\/span><\/span> On successful admission as a member to CIMAA, I agree to be bound by its rules.\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap kc_captcha cf7ic-toggle\" data-name=\"kc_captcha\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"captcha-image\" style=\"display: none;\"><span class=\"cf7ic_instructions\">Please prove you are human by selecting the<span> house<\/span>.<\/span><label><input aria-label=\"1\" type=\"radio\" name=\"kc_captcha\" value=\"kc_human\" \/><svg width=\"50\" height=\"50\" aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 576 512\"><path fill=\"currentColor\" d=\"M488 313v143c0 13-11 24-24 24H348c-7 0-12-5-12-12V356c0-7-5-12-12-12h-72c-7 0-12 5-12 12v112c0 7-5 12-12 12H112c-13 0-24-11-24-24V313c0-4 2-7 4-10l188-154c5-4 11-4 16 0l188 154c2 3 4 6 4 10zm84-61l-84-69V44c0-6-5-12-12-12h-56c-7 0-12 6-12 12v73l-89-74a48 48 0 00-61 0L4 252c-5 4-5 12-1 17l25 31c5 5 12 5 17 1l235-193c5-4 11-4 16 0l235 193c5 5 13 4 17-1l25-31c4-6 4-13-1-17z\"\/><\/svg><\/label><label><input aria-label=\"2\" type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg width=\"50\" height=\"50\" aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 640 512\"><path fill=\"currentColor\" d=\"M624 352h-16V244c0-13-5-25-14-34L494 110c-9-9-21-14-34-14h-44V48c0-26-21-48-48-48H48C22 0 0 22 0 48v320c0 27 22 48 48 48h16a96 96 0 00192 0h128a96 96 0 00192 0h48c9 0 16-7 16-16v-32c0-9-7-16-16-16zM160 464a48 48 0 110-96 48 48 0 010 96zm320 0a48 48 0 110-96 48 48 0 010 96zm80-208H416V144h44l100 100v12z\"\/><\/svg><\/label><label><input aria-label=\"3\" type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg width=\"50\" height=\"50\" aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 384 512\"><path fill=\"currentColor\" d=\"M377 375l-83-87h34c21 0 32-25 17-40l-82-88h33c21 0 32-25 18-40L210 8c-10-11-26-11-36 0L70 120c-14 15-3 40 18 40h33l-82 88c-15 15-4 40 17 40h34L7 375c-15 16-4 41 17 41h120c0 33-11 49-34 68-12 9-5 28 10 28h144c15 0 22-19 10-28-20-16-34-32-34-68h120c21 0 32-25 17-41z\"\/><\/svg><\/label>\r\n    <\/span>\r\n    <span style=\"display:none\">\r\n        <input type=\"text\" name=\"kc_honeypot\">\r\n    <\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Join CIMAA Victoria\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<span style=\"color: #00ff00;\">You will be sent an email with EFT details for payment &#8211; if you do not receive an email please contact the Victorian Secretary.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>It is 2025&nbsp; &#8211; we no longer accept Cheques or Money Orders or Cash payments &#8211; EFT only! If that is not possible, or if you don&#8217;t have an email address you&#8217;ll have have to contact the Membership Secretary using &hellip; <a href=\"https:\/\/cimaa.asn.au\/index.php\/victorian-application-form\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-286","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/cimaa.asn.au\/index.php\/wp-json\/wp\/v2\/pages\/286","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cimaa.asn.au\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cimaa.asn.au\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cimaa.asn.au\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cimaa.asn.au\/index.php\/wp-json\/wp\/v2\/comments?post=286"}],"version-history":[{"count":14,"href":"https:\/\/cimaa.asn.au\/index.php\/wp-json\/wp\/v2\/pages\/286\/revisions"}],"predecessor-version":[{"id":5401,"href":"https:\/\/cimaa.asn.au\/index.php\/wp-json\/wp\/v2\/pages\/286\/revisions\/5401"}],"wp:attachment":[{"href":"https:\/\/cimaa.asn.au\/index.php\/wp-json\/wp\/v2\/media?parent=286"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}