Membership Application Form


First Name: 
Surname: 
Phone: 
Mobile: 
Email: 
Street Address: 
Suburb: 
Town/City: 
Occupation Type: 
Membership Type: 
MNZ Number: 
   I agree to my details being published in 'Cycle Torque' magazine
   or   
Note:If Emailing please deposit your Membership Fee into Ixion's Account using Internet Banking.
IXION MOTOR CYCLE CLUB
Account No. 03 0502 0068232 00
Your form will not be proccessed until fee has been paid.
 
 
 
 
 

Fee: Senior $40.00 - Junior (14 & under) or Social $20.00
 Please post, along with your Membership fee, to...
 
 
   Ixion Motor Cycle Club
   P.O. Box 57127
   Mana
 

© Copyright 2010 by Ixion MCC - Page dated 23-July-2010