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Register
Thursday, February 23, 2012
Membership Renewal Form
Your Details
Name
Postal Address
City
State
NSW
Qld
SA
Tas
Vic
WA
Phone No
Mobile No
Email
Date of Birth
please use DD/MM/YYYY format
YA No
Boat Details
Are you & your Moth registered with Yachting Aust?
No
Yes
ie. do you have a ‘KA’ or an ‘AUS’ sail number, a valid measurement certificate, and a Yachting Australia membership card?
Boat Type
Foiler
Scow
Skiff
Boat Name
Sail No
Yacht Club
Payment Details
Membership Category
Full $65
Junior $50
Junior Membership (Under 19 at 31/12/2011)
Cheque
Please make all cheques payable to the IMCA of Australia and post to IMCAA 6 Crown St Henley 2111
Direct Deposit
Please deposit amount into NAB account and use your sail no as a reference
BSB: 082 663 Acc Number: 55 556 1653 Acc Name: International Moth Class Association (Aust) inc
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