New Members Application – Highway Wanderers

Thank you for your request to join the Highway Wanderers. Please fill in the membership questions below and SUBMIT the form. The form will be sent to the Membership Officer & Treasurer. Upon receiving your completed form and PAYMENT of our Administration Levy (including a one-off New Member Joining Levy), your Membership Pack containing many Highway Wanderer goodies will be sent to you. We look forward to welcoming you to our Chapter and meeting you on the road somewhere.

Our $15 annual Administration Levy falls due on June 30 each year.

New Member Joining Levy if you join between:

Jul 1 – Dec 31: $20. Next payment due by the following June 30

Jan 1 – Apr 30: $15. Next payment due by the following June 30

May 1 – Jun 30: $20. Next payment due by June 30 of the following year

*All fields with red asterisks must be completed before the form will SUBMIT.

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CMCA Membership No. (Including the Prefix letter indicating your State of residence)

Primary Members Name

First

Last

Preferred Name

Postal Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Primary Member Facebook Name (Including any dots and numbers)

Primary Members Email

Primary Member Postcode

Primary Members Mobile Phone (use Home Phone if you have no mobile)

Primary Members Birth Month (Not birth date)

Primary Member Home Chapter

Second Members Name

First

Last

(Second person with same CMCA membership number as Primary Member) Please ensure you complete all details below for the second person when there is a second person entered.

Second Members Preferred Name

Second Member Facebook Name (including any dots or numbers)

Second Members Email

Second Member Postcode

Second Members Mobile Phone ( use Home phone if no mobile)

Second Member Birth Month (Not birth date)

Second Member Home Chapter

(The CMCA requests that members nominate just one chapter as their Home Chapter for their records. If you are not a member of another Chapter this can be Highway Wanderers).

Where did you hear about Highway Wanderers?

Please tell us how you heard about Highway Wanderers

Any further comment or question.

Agree to Confidentiality of Information

I/we agree to my/our name and basic information being available to other members of the Highway Wanderers and agree to treat other member's information with utmost confidentiality.

Agree to PRIVACY POLICY

I/we have read and understand the PRIVACY POLICY and agree to abide by it.

Agree to SOCIAL RESPECT POLICY

I/we have read and understand the SOCIAL RESPECT POLICY and agree to abide by it.

Name

Click here: PRIVACY POLICY

Click here: SOCIAL RESPECT POLICY

Click here: PAYMENT INFORMATION

You will be contacted by our Membership Officer as soon as your membership is approved.

A very warm welcome from the Highway Wanderers.