MEMBERSHIP APPLICATION
Tiger Moth Club of New Zealand inc
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Last name *
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Postal Address *
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Post Code *
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Email:
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Communications will be by email unless requested othewise
Home Phone:
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Work Phone:
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Mobile:
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Aircraft:
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Licences Held
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$20.00 Annual Subscription (Year ends 31st December)
Voluntary Donation = $
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Total Paid = $
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Please Make Cheques payable to
Tiger Moth Club of NZ inc
Postal Centre 14,
Papakura, 2244
Auckland
New Zealand
Internet Banking to
ASB 12 3194 0023828 00

Please ensure you include your name as reference when making an internet deposit
Any questions please contact Amanda Rutland (treasurer) at tigermothclub@gmail.com
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