Membership Application Form

Personal Details

First Name *

Last Name *

Number, Street Name, Suburb *

NZ Post Code / Zip Code

Postal City

Region

Country

Email *

Password *

Phone Number

Mobile Number

Partner's Details

Partner's First Name

Partner's Last Name

Partner's Email

Registers

Car 1

Engine Capacity, Manual/Auto

Car Registration 1

Car Year 1

Car Colour 1

Car Condition 1

Car 2

Engine Capacity, Manual/Auto

Car Registration 2

Car Year 2

Car Colour 2

Car Condition 2

Car 3

Engine Capacity, Manual/Auto

Car Registration 3

Car Year 3

Car Colour 3

Car Condition 3

Car 4

Engine Capacity, Manual/Auto

Car Registration 4

Car Year 4

Car Colour 4

Car Condition 4

Car 5

Engine Capacity, Manual/Auto

Car Registration 5

Car Year 5

Car Colour 5

Car Condition 5

Car 6

Engine Capacity, Manual/Auto

Car Registration 6

Car Year 6

Car Colour 6

Car Condition 6

Car 7

Car Type 7

Car Colour 7

Car Registration 7

Car Year 7

Car Condition 7

Car 8

Car Type 8

Car Registration 8

Car Year 8

Car Colour 8

Car Condition 8

Member Data Access Options

Name, phone number and email address (ONLY) available to other members of the Auckland Jaguar Drivers Club *

YES
NO

The applicant agrees that the information on this application will be available to Committee Members of the Auckland Jaguar Club and Model Register Coordinators who have agreed to confidentiality conditions *

YES
NO

Applicant agrees that the Auckland Jaguar Drivers Club Membership Secretary (ONLY) will have access to and be able to edit membership details upon a request from the member or if required. *

YES
NO

I agree to the Security and Privacy Policies

Subscriptions		Fee	Annual
	Membership	$43.48	$104.35
Total			$0.00

Note

All prices exclude GST

Order Number

Which image is the Bed?

   

NOTE: - This information is required by the Jaguar Drivers' Club (Auckland) Inc. in order to keep you informed of the club's activities and for the club's statistical purposes only. Your details will be stored as submitted on the club's server. The information provided will only be available to the Secretary, President, Treasurer and committee members. The information will not be disclosed to any other individual or organisation without your prior consent. Please ensure that you complete this form in its entirety as the accuracy of our club records depends on you!

1	SS1
2	SS1 ROADSTER
3	SS100 REPLICA
4	SS2
5	JAGUAR SALOON
6	JAGUAR DROPHEAD
7	XK 120 FHC
8	XK120 DHC
9	XK 120 OTS
10	XK 140 FHC
11	XK 140 DHC
12	XK140 OTS
13	XK 150 FHC
14	XK 150 DHC
15	XK 150 OTS
16a 16b	XK150-3.4S FHC XK150-3.8S FHC
17a 17b	XK150-3.4S DHC XK150-3.8S DHC
18a 18b	XK150 3.4S OTS XK150 3.8S OTS
19	C TYPE REPLICA
20	D TYPE REPLICA
21	MK 5
22	MK 5 DHC
23	MK 7
24	MK 7 M
25	MK 8
26	MK 9
27	MK 10
28	420 G
29	MK 1
30	MK 2
31	240
32	340
33	SP250 DAIMLER
34	V8 250 DAIMLER
35	S TYPE (OLD)
36	420
37	420 DAIMLER
38a 38b 38c	E TYPE S1 3.8 FHC E TYPE S1 3.8 OTS E TYPE S1 3.8 2+2
39a 39b 39c	E TYPE S1 4.2 FHC E TYPE S1 4.2 OTS E TYPE S1 4.2 2+2
40a 40b 40c	E TYPE S1.5 4.2 FHC E TYPE S1.5 4.2 OTS E TYPE S1.5 4.2 2+2
41	E TYPE S2 FHC
42	E TYPE S2 2+2
43	E TYPE S2 OTS
44	E TYPE S3 2+2
45	E TYPE S3 OTS
46	XJ6 S1
47	XJ6 S1 DAIMLER
48	XJ6 S2
49	XJ6 S2 DAIMLER
50	XJ6 S2 C
51	XJ6 S2 C DAIMLER
52	XJ6 S3
53	XJ6 S3 DAIMLER
54	XJ6 S3 SOV
55	XJ6 40
56	XJ6 40 DAIMLER
57	XJ6 40 SOV
58	XJ6 40 SPORT
59	XJ6 R 40
60	XJ6 300

61	XJ6 300 DAIMLER
62	XJ6 300 SOV
63	XJ6 300 SPORT
64	XJ6 R 300
65	XJ6 (ALUMINIUM)
66	XJ12 S1
67	XJ12 S1 DAIMLER
68	XJ12 S2
69	XJ12 S2 DAIMLER
70	XJ12 S2 C
71	XJ12 S2 C DAIMLER
72	XJ12 S3
73	XJ12 S3 DAIMLER
74	XJ12 S3 SOV
75	XJ12 40
76	XJ12 40 DAIMLER
77	XJ12 40 SOV
78	XJ12 40 SPORT
79	XJ12 300
80	XJ12 300 DAIMLER
81	XJS 5.3
82a 82b	XJ SC V12 XJ-SC 3.6
83a 83b	XJ-S CONV' V12HE XJ-S CONVERT 3.6
84a 84b	XJ-S 5.3 HE XJ-SC V12 HE
85	XJRS 6.0 HE
86	XJ8
87	XJ8 DAIMLER
88	XJ8 R
89	XJ8 ALUMINIUM
90	XJ8R ALUMINIUM
91	XK8
92	XK8 CONVERTIBLE
93	XK8 R
94	XK8 R CONVERTIBLE
95	S TYPE (NEW)
96	S TYPE SPORT
97	X TYPE
98	X TYPE SPORT
99	XK
100	XK CONVERTIBLE
101	XKR
102	XKR CONVERTIBLE
103	XJ 13 REPLICA
104	PANTHER
105	SPECIAL
106	XF
107	XFS
108	XFRS
109	XJ SALOON NEW
110	F TYPE
111	F TYPE S FHC
112	F TYPE S CONV'
113	F TYPE RS
114	F-PACE
115	-
116	-
117	-
118	-
119	SWALLOW COUPE
200	SWALLOW DHC