Ducati Owners Club of Queensland © 2010

New Member Application Form

This is not a Renewal form to Renew, please contact the Members Secretary.

Personal Details

Note Fields with * are compulsory.

Member Interests

Day Rides:		Rallies:	Social Events:
Track Days spectator:		Track Days Rider:	Race Meets Spectator:
Race Meets Rider:		Restoration:	Assisting Club:
Other Interests: *	* *Please seperate Other Interests with comma's.

Membership Information

Username / Nick *:		Nick Name, or Unique Tag for Message Boards etc
Login Email:*			For Login to Members Area.
Login Password:*		Password you would like to Login to Members Area
Magazine Delivery:	^Note		^note Download from website recommended for online method
Membership can be paid by cheque or direct Internet payment. An email will be sent once this form has been processed with more details. The members secretary will process application usually within 7 days, of receiving payment; Full year membership: 1st January to 31st December - $35.00

All information gathered is confidential and not distributed to any third party.