Your Name        
Spouse's name
Children's names 
Became aware of the Club by     

Please deposit your membership fee, or post a cheque made payable to:
 Four Wheel Drive Club of KZN to: P.O. Box 1405, Westville, 3620.
Registration Fee R60                
Driver training Fee R60                  
Annual subscription (R350)       (R175 from 1 July)
Amount deposited      

(please note: the Club's financial year is from 1st November to 31st October each year, and the annual subscription will therefore be calculated on a pro-rata basis for members joining after the 30 June)
(to deposit directly into our account, contact Memberships for bank account details)

Please note the Members Code of Conduct

I/we, the undersigned do hereby apply for membership/renewal of membership of the FOUR WHEEL DRIVE CLUB OF SOUTH AFRICA and if accepted agree to abide by the constitution and rules of the Club and acknowledge that I/we participate in the Club's activities at my/our own risk.

Full name    Date 

Please complete the following questionnaire

Address                                            
     

Tel no (H)        Tel no (W)  
Fax no             Cell phone 
E-mail address:

Occupation:

Vehicle make, model and registration no.   

I/we have training in ... Copy of your accreditation certificate / driver training certificate to be faxed to 0865140737.

Vehicle equipment (please indicate with a tick)
    winch              2-way radio          Hi-lift jack          
    tools               spade                    pick                   
    pump              GPS                      compass          
    spots              fog lights               backup battery 
    tyre pressure gauge 
  
Engine modifications  

Club activities/interests
please indicate in order of preference (i.e. 1st choice - no 1) which of the Club's activities/services are most likely to be of interest/use to you. Please number all.
    a) day outings                        b) extended outings   
    c) evening functions              d) motorsport             
    e) technical/equipment         f) rescue/recovery       
    g) conservation/environs.     h) driver training         
    i) trails                                     j) information              
    k) other   

Thank you for joining the Club and taking the time to fill out our interest questionnaire.  We hope you enjoy your time with the Club. If you have any questions please feel free to contact Shavaun Lesch.