INTHISISSUE
VALE-NevilleMansfield,Page4
HowtoIndentifyHighTensileBolts,Pages5-6
SocialsPage-TTTDay&ClassicSuperSprint,Page7
TTTDay&ClassicSuperSprintbyJohnCarson,Pages8-9
HistoricFormulaVbEligibilityDateExtension,Page10
AutumnClassicSpeedfest,Page11
ClassicQld,Page12
2025HRCCSocialEventsCalendar,Page13
2025QueenslandHistoricMotorsportCalendar,Page14
Classifieds,Pages16-18
HRCCMembershipApplicationForm,Pages20-22
Helloall,
Well,theFebruary TTThasbeenrunandenjoyedbyallattendees. Wegot4practicerunsonSaturdayand3-4 sprintsessionsonSunday,whichwasplenty. DidyouknowtheTTTwasoriginallyconceived asaHRCCmember practice weekend?
The2025MotorsportcalendarthisJanuary/ Februarywasunusuallybusy,withschedule clashesagainstothertrackeventsinNSWand hereinQLD.ThisimpactedTTTnumbers,which werelowerthanusual.That’sfine–it’sjustthe wayitworkedout.Somemembersandother punterssimplyoptedforothereventsinsteadof theclub’sTTTpracticeweekend.
So….HRCC’s3officialracingweekendsarenow onthehorizon.KeepaneyeonourFBpage/ website,readthenewsletterandreachoutto clubrepsforupdates.
Raceweekend#1–HRCCAutumnClassic Speedfest–MorganParkMay9th–11th Theeventflyeris attached.
ThiswaspreviouslycalledtheAutumnHistorics. Thenamechangeisjustthat-itisstillHRCC’s bigAutumnmeeting.
TheMSAentryportalwillopeninthenextweek orso.WeawaitapprovaloftheSupplementary RegulationsfromMSA.Assoonastheyare processed,theportalwillbeopened.
Pleasenote:Forour3raceweekendsthisyear, wehaveremovedtheearlybirdentrydiscount.
InsteadwehaveincreasedtheHRCCMember discounttoasubstantial$70perevent.
FROMTHE PRESIDENTS DESK
JustareminderwearetriallingSaturdaynight socialsatthetrackin2025.FortheAutumn meeting,wewillkickoffassoonasracing finishes,around4:30pminthepits.Thisyear, we’vehiredalocalWarwickMusician,Luke Costelloandhisband,toentertainus.Wethink hislaid-backstyleiswellsuited. Ifyouarecamping,youwon’thavefartowalk home!
Therewillbefoodanddrinksforpurchase.For thebudgetconsciousamongstus,youwon’t needtodrivetoWarwickfordinner. Let’sallsupportthisinitiativeandenjoyan eveningunderthestarswithfamilyandfriends.
PracticeDay–HRCCmemberonlypractice day–5th June1-5pm-QldRaceway
Wehavescheduledthis1monthpriortothebig Julyracemeeting.Thisisamemberonly practiceafternoon.
Weplantorunonthetracksbeingusedfor CLASSICQLD.Weencourageyoutotakethis opportunityfortracktime.
Entrywillbeontheday,sojustrolluptoQRand paywhenyougetthere.We’llsendreminders closertothedate.
Onceagain,ifyousupportthisotherinitiative wecanmakeitaregularannualeventonour calendar.
RaceWeekend2–CLASSICQLD–Qld Raceway,Willowbank-Jul4th–6th
Theeventflyeris attached. Therewillbeafaircontingentofinterstate entries,solet’smakethemfeelwelcome.
TheSaturdaynightpartywillbeheldonthe rooftopareaatQR.Thiswillbeacateredfood andbeverageevent.Wewillaskyoutoconfirm attendanceaswegetclosertotheevent.
AccommodationusedtobeachallengeforQRevents.
However,dideveryoneknowthatgoodcampingisnowavailableatQR?Alternatively,Springfield Lakesisaround18minutesdrivefromthetrackandoffersnumerous3-5staraccommodation options.
ThisJulymeetinghasanumberofinterestingfacetstoit.
� GROUPNwillberunningafullgridateachofour3racemeetingsthisyear.
� F5000s-Atthisstagetheyadvisethatbetween15and25oftheircarswillattend.
� OffTrackDisplay/concoursonSunday6th -ThisisbeingmanagedbyBillWesterman,supportedby JohnCarsonandothers.Thedisplaywillincluderacecars,classiccarsandmotorcycles.
� TheHistoricMotorcycleClub(HMCCQ)arejoiningusforCLASSICQLD.Didyouknowtheyhave around1700QLDmembers!Theirmanagementcommitteeexpectatleast60bikesatourevent, whichwillreallyaddsomespicetotheweekend.
� We’vespokentoaselectnumberofcarclubsaboutjoiningthedisplay.Interestfromsomeclubs isstrong.
Advertisingwillbedonevianewspapers,radiosandbillboards,inadditiontoourusualsocialmedia andinternetmethods.TheQldRacewayteamandSpeedCaféwillbeusingourmarketingmaterialsto getthewordout.Weareexpectingsignificantspectatornumbersforthisevent.
Raceweekend3–SpringClassicSpeedfest–MorganPark–17th-19th October
Thisisourfinaltrackeventof2025.Wewillmoveourfocustothis,oncetheothereventshavebeen run.
Onafinalnote,it’scleartheHRCC’scontributionstotheOilyRaghadfallenaway.We’vere-engaged withthemagazineeditorandwillaimtogetourkeyinformationintoeachmagazine.
HaveagreatMarchandchatagainsoon.
Regards,Chris
VALE-NEVILLEMANSFIELD
20May1944–19February2025
ItiswithgreatsadnesstoadvisethatoneofthefoundingfathersoftheHRCCQhasleftus.
NevillewasanenthusiasticmemberoftheHistoricRacingRegisterQldwhichwasinvolvedinthe amalgamationandformationofourClub.Infact,thefirstinformalmeetingwasheldatthe Mansfield’shomeatKedron.
NevillewasanAustinHealySpriteaficionado,andowned,raced,sprintedanddrovemanycarsand events,rightuptohisdeath.
Hewasasourceofencouragement,expertadviceandgreatenthusiasm.
Whenhisbelovedwife,Irene,ahugesupporterandbusinesspartner,diedsomeyearsago,andhis onlysonandbestmate,Troy,passedawaymorerecently,ahugespacewasleftinNeville’slife.
HehasalwaysbeenclosetohislovingdaughterTrudie,son-in-LawJohnandTroy’sdaughterElla,and Helen,whowillmisshimgreatly,aswillhismanyfriendsandrelations.
TheHRCCQpassontheircondolencestoNeville’sfamilyandfriends.
Funeraldetails:
Date:Tuesday4thMarch11am
Location:AlbanyCreekCrematorium,400AlbanyCreekRoad,BridgemanDowns. Familyrequest:Werequestthatpeoplewearsomethingbright.Dadlovedhispartyshirts. Helovedhowtheymadepeoplesmile.Alsowelcometowearanyclubshirts.
HOWTOINDENTIFY HIGHTENSILEBOLTS
(Takenfromthis post byChampionParts.Republishedwithpermission.Editedforpointof viewandrelevance.)
Hightensileboltsareusedinapplicationswheredurabilityiscriticaltofirmlyandsafelyhold componentstogether.
Acommonexamplewouldbeinanautomotivesystem,wherehightensilebolts: 1.Holdtogetherthelinkagesofthesuspensionsystem;or 2.Attachthebrakecaliperstotheknuckles
Gettingthisrightisimportantforobviousreasons:safety,reliabilityandthelongevityof components.
ThisexcerptfromChampionPartsmightpointyouintherightdirection.
Disclaimer: AIMSisnotanexpertinfastenerdesign,thereforetheinformationprovidedherein shouldnotbetreatedasprofessionaladvice.Theofficialsourceiscited.
Readtheheadmarkings
Themarkingsontheheadfaceofaboltcanbeconfusing.Howdowespecifythegradesbetween eachpatternandmakesureyougetthecorrectsize?
1.Checkifthereareanyheadmarkings.Theywillindicateiftheboltismetricorimperialandthe grade/class. Hereishowyoucandeterminethecorrectbolttouseforyourheavy-duty application.
2.Lookatthethreadedpartofthebolt/setscrewandidentifyifitisafinethreadorcoarsethread. Usingavernier,measurethediameterofthethreadedpartofthebolt/setscrew,asshowninFig.1.
3.Useapitchgaugetodeterminethepitchofthethread,asshowninFig.2.
4.Usingaruler,measurethelengthofthefastenerfromunderthehead,asshowninFig.3.
Corrosionprotection
Apopularoptiontoavoidcorrosioniszincplating,whereametalbondisformedbetweenthesteel andthezinc,whichservesasaprotectivelayer. Zinc-platedfastenersareideallyusedindryenvironments.Otherwise,stainlesssteelfastenersmaybe abetteroption.
Colour
Thecolourofthefastenerisdeterminedbyapigmentadditiveduringtheelectroplatingprocess.That iswhysomefastenersappeartobegold(yellow-ish)orsilver(clear)incolour. Theydoitjusttoenhancetheappearanceofthefastener. Itdoesnothaveanythingtodowithdurability.
SuppliedbyBruceRichards
MotorsportAustraliaTechnicalDelegate
EVENTSOCIALSPAGE
TTTDAY&CLASSICSUPERSPRINT-15-16FEBRUARY2025
byPaulRitchie
Well,whataperfectwaytocommenceourracecalendar for2025,withthe original andthebestTTTmeetingon theSaturdayfollowedbysomefiercecompetitionand seriousfunontheSunday.
Yes,I'mreferringtotheHRCC’sannualmeetingheld prettymucheveryFebruaryforaslongasIcan remember.
ThevenuewasheldatthepicturesqueMorganPark RacewayinWarwickQueensland,thiscircuitisoneofthe betterplacestodriveyourracecarinarelativelysafe environment.
Theentireweekendwasremarkablyfreeofincidentsand breakdowns,itseemsthelargermajorityorcompetitors hadtheirracecarswellsortedoutpriortoarrival.
TheHRCCkindlyhostedthe"SausageSizzle& Refreshmentsgettogether"inthetrackrestaurant immediatelyaftertheTTTonSaturdayafternoon.The HRCCconsiderthisveryspecialeventwithintherace weekenddesignedtothankthetrackmarshals,official's andallvolunteers.It’sachanceforcompetitors&the marshalstogettogetherandmeetoneanotherandwith approximately100peopleturningoutitwasanother greatsuccess.
PhotosbyTrapnellCreationsPhotography
15-16February2025
byJohnCarson
NatalieandDouglasAndersonswapped ridesontheSaturdayintheirElfinCatalina.
GayleMorgankeepsLiamRedmanandhis niftySpritedry.
ChrisFarrell’steaminsupport.
BrettonFlagsatlastcorner beforeFinishLine.
GeoffBroad,Porsche914, getsfinalinstructions!
Hyundaigraphicsarevelationinelectric colour.
NewMPScrutineeringpresentationawinner!
Thebestof1970sBritish,JapaneseandItalianambience.
ItwasatadgustyforGayle andDavidMorganwhodida 1.35.88PB.
JonathonCamp,YellowVanDieman,fastat1.22.67.
PaulRitchietightensthestrapsjustone morenotch.
HISTORICFORMULAVEE
VbEligibilityDateExtension
PleasenotethatMotorsportAustraliahasupdatedthe2025HistoricVehicle Eligibilitydocument“4.03-SportsandRacing:F,J,K,L,M,O,P,Q,R,T,Vand F5000”.
ThegroupisintendedtocaterforFormulaVeeracingcarswithacompetition historyestablishedintheperiodbetween1January1975and31December 1985andhasnowbeenextendedto31December1991.
Todownloadthewholedocumentclick here.
GROUPLEADERS
RaceCommitteeChairman
AlanSteel 0421349950 trackcraft1@bigpond.com
GroupLeadersCoordinator DavidPaterson 0423392824 david.paterson@chrobinson.com
GroupsA&C(HeritageTouring Cars)
GroupF(HistoricFormulaFord)
DavidPaterson 0423392824 david.paterson@chrobinson.com
GeoffKarger 0417636106 gkarger@optusnet.com.au
GroupV(HistoricFormulaVee) AlanDon 0401952448 spit5@hotmail.com
GroupsJ,K,&L(HistoricSports andRacing)
CraigCarlson 0418191648 craig@envirohealth.com.au
GroupN(HistoricTouringCars) Vacant
GroupsS&T(Historic ProductionSportsCars)
GroupsM,O,Q,R(Historic SportsCars)
GroupsM,O,P,Q,R(Historic RacingCars)
PeterRichards 0408957966 peter.richards@paccon.com.au
MikeGehde 0413651867 gehde@guardianinvestments.com.au
BarryWise 0415318913 barryjanwise@spin.net.au
GroupU(HistoricSportsSedans) Vacant
TimedTrials(formally Regularity)
AndrewWhite 0473435606 acw46motorsport@gmail.com
Website&HistoricTorqueEditor LisaCatchpole 0407504755 lisa.p.catchpole@outlook.com
ClubPhotographer PeteTrapnell 0418737912 info@trapnellcreations.com
ConcessionalRegistration Officer
HistoricEligibilityOfficers
JimGoulden 0400525865 info@hrcc.org.au
BruceRichards 0419675020
PeterHerlihen 0414474408
CLASSIFIEDS
ExpressionofInterest
TheFabulousNotaDin
TheNotaDin(ChassisNumber40)wasthelast& mostsuccessfulMonopostoracecarbuiltbytheNota factory.Poweredbyawell-developed6cylinder HoldenGreymotordrivingthroughaPeugeot gearboxandaSkodarearaxle,theNotaDinneedsno introductionandisawell-knownHistoricracerhaving beenregularlycampaignedoverrecentyearsatGEAR eventsacrossNSWandatvariousHistoricmeetings. LappingWintonShortTrackataround1.12thisisa fast,reliable,immaculateandverywell-known Historicracer.
Inadditiontothecarthereareanumberofsupport partsincludingaDiff,Gearboxes,Sparewheels& assortedbits&pieces.Ashortmotorwhichhasbeen machined&isreadytobeassembled(Newpistons, conrods,mains&bigendsbearings,newcam bushesetc.)isalsoavailableandincludesaverywell developedcylinderheadmodifiedforoptimum performancewhichhasonlyjustbeencompleted.
Thecarisbeingofferedforsalewithanimmaculate custombuiltaerodesigneddualaxletilttrailerwhich hasallthestandardrequirementssuchasapowered winch,fixreardoorramp,side&frontdoors,electric bakes,duelsparewheels,rolloutsidecanopy,(3 meterssquare)sofullcarcoveragewheninuseand isonfullNSWregistration.
Thisisaturnkey,fullysorted&freshHistoricracer completewithdocumentedhistoryincludingAASA& CAMS/MotorsportAustralialogbooks&COD.
CATERHAMLOTUS7(CosworthBRG)
Iamsellinga1990CosworthLotus7,withthe16 valveBDGmotor.
Thecarhasjusthadextensiverebuild,been repaintedindarkBRG. Motorhasnewheadandbottomendcheck. New40mmWebbers,5speedSieragearbox,new seats,newlights,allnewhosesandbelts. Haswidebodyguardswith10x13rearand8x13 frontswithF3softgroovedtires(virtuallynew),plusa setofstandardlotusroadwheels. Thecarhasaeroscreensbutalsocomeswitha standardroadscreen.
Absolutelynothingtospend.Theperfectroad/track car.
1971LanciaFulviaSport1600
HistoricRaceCar
� LogbookedGroupSbwithsealedengine
� Freshlyrebuiltengine1:54atSMSP
� Newstraightcutsynchrocloseratiogearbox withshortshifter
� FreshlyrebuiltBrakeBoosterandMaster cylinder
� 45mmDellortoCarbiesonFacettiInlet Manifold
� Group4exhaustmanifoldwithS/Sexhaust systembyHitechMufflers
� HighcompressionpistonswithgaplessTotal Sealrings
� ArgoRods
� Originallargecapacitysand-castsump.
� LumentionElectronicIgnitionSystem.
� BondRollBarsfullSafetycage
� 54lAlloyfueltankbyBondRollBars
� 14”CromodoraRimswithnewYokohama AdvanA050195/60tyres
Ongoingtechnicalsupportavailable.
1968MorrisMiniCooperS,GroupU LogBookedHistoricSportsSedan
History: Competitionhistoryfrom1977,mainlyraced Amaroo&OranParks
Restoration: Completedto1983specforCODpurposes. Livery:RapidTransport Mechanicals: 1380cc(newbuildbyKenNelson)RussellHead, CAM.AllthebestcomponentsIcouldaffordfor reliability&performance.Diff:MEDLSDratio 3.9:1Gearbox:StraightcutRemoteShift Paint: 2packfreshtotalrespray(2020–GC Restorations)
Wheels:
OriginalsetMawer13x8.5”,10x8”,13x8”. CustommadeMawer13x9”,10x8”
Tyres: HoosierRadialSlicksfrontandrear,2nd setAvon radialfront
Brakes: MorrisMarinaCallipers(front),MorrisMinidrums (rear),MasterCylTriumphStag
Waymorethanaskingspentonthecarasbuiltto racenotreluctantlysell. Happytoansweranyquestionsasthecarhas beenapassionover3yearsoftheresearchand buildprocess.
CLASSIFIEDS
WELSORWAGGOTTGROUPQCLUBMAN
BuiltbyWelsor(ColinWear)in1972thiscarwasvery successfulinstatechampionshipsinthehandsof WelsorworksdriverDavidSeldon.
ItwasthefirstWelsortofeatureabeamfrontaxle withradiusarmsandWattslinkagethatprovides extremelygoodhandlingandenablesverylate brakingplussimplicityinfrontwheelalignmentand camberadjustment.
ToquoteColinWear“withthebeamaxlethere'sno camberchangeunderbrakingsothefullwidthofthe tyrecanapplythebrakingforces".
RearsuspensioncomprisestrailingarmsandBMCdiff withfullyfloatingaxlesandbothfrontandrear suspensionsfeatureadjustablecoil-overAVOsprings andshockabsorbers.
Discbrakesallroundwith8”frontand10”rearrims fittedwithnearnewAvonslicks.
ItispoweredbyaCorolla3Kengine(1298cc,twin45 DCOEWebers,drysump,electronicignition,etcwith CarillopistonsandSpoolconrods)andacloseratio4speedCorollagearboxwithModenagearsandshafts.
Ihaveownedthecarsince2003anduseditmainlyin historicracingandtheMorganParksprintsanditis inverygoodcondition.
Itisrealisticallypricedtosellat$29,500onoand comescompletewithCofDandagoodassortment ofsparesincludingspareblocksand3Kbigport cylinderheads.
ThecarishousedinBrisbane.
1965RAMBLERCLASSIC660CROSS COUNTRYWAGON
BuiltatAMIPortMelbourne,oneofonly185in 1965,thisAmerican/Australianbeautywas discovered,unrestored,inAdelaidein2009and drivenhometoBrisbanebythecurrentowner.
In2010,allrustwasremovedandafullbody structuralrestorationwascompletedbyPebble BeachawardwinningSleepingBeauties,Brisbane.
Astunningduotonerefinishresultedinawhite turretoverlayingalowerbodyinbluewhilst internallytheoriginalredtrimoffsetstheAMCtricolourred,white&bluepresentation.
Overtheyearsmechanicaloverhaulshave returnedthiswagontoahighlevelofon-highway cruisingabilityanditfeaturesatowbar.
In2021/2acompleteengineoverhaulwas completedbyMarkandGarryHammondof Capalabaandthecarwaslastdisplayedat CabooltureAerodrome&theTambourineClassic CarShowsofmid2024.
Personalisedplates,subjecttostatelaws,are includedinthesale.
CONTACTUS
GENERALENQUIRES: 0424321072
EMAIL:info@hrcc.org.au
ClubOfficers
President ChristopherFung 0428725653 chrisfungconfidential@gmail.com
Secretary AlanSteel 0421349950 trackcraft1@bigpond.com
Treasurer PeterFinnigan 0433758263 peterfinnigan1958@gmail.com
Committee/Membership JimGoulden 0400525865 jim@jandwgoulden.com
TELLUSYOURSTORY!
Whynotshareyourstorywithusthroughthenewsletter.Itmightbethecaryourbuilding.an eventyourecentlyparticipatedorofficiatedinoryourtravelswithyourprideandjoy.All contributionsforupcomingissuesofHistoricTorquearewelcome.Pleasesubmityourstory andphotostotheeditoratlisa.p.catchpole@outlook.com. Alternatively,postarticlestoTheEditor-HistoricTorque,POBox353,RedHillQld4059. Pleaseincludeastampedselfaddressenvelopeforthereturnofyourpreciousphotos. Deadline-12th dayofeachmonth
Disclaimer: HRCCQldacceptsnoresponsibilityfortheresultsofcontributors’advice,nordoesit necessarilyendorseanyservices/products/goodsofferedbyadvertisers.Itisarequirement thatallarticlespublishedareaccompaniedbythenameoftheauthor.Opinionsexpressedin thenewsletterarenotnecessarilythoseofthisClub,itsOfficersoritsEditor.Comments/ opinionsmadebytheEditorarealsonotnecessarilythoseoftheCluboritsOfficers.Items originatingfromthenewslettermaybereprintedbutacknowledgmentwouldbeappreciated. Publishedphotographsarethepropertyofthephotographersandmaynotbereproduced withouttheirpermission.
HISTORIC RACING CAR CLUB (QLD) INC.
MEMBERSHIP APPLICATION FORM
Important notice to all potential members
The Historic Racing Car Club (Qld) Inc. has Public Liability Insurance cover of $100,000,000 through the affiliation with Motorsport Australia.
SECTION 1 PERSONAL DETAILS
Surname:
Postal Address:
Given Name:
Mobile: Birth Year: (Optional)
Email:
Motorsport Australia Licence Number: (If available)
Postcode:
Additional Family A – Full Member ($30) (Nominate the name of primary full member)
Primary Member Name:
Referring Member Name: (Optional)
NOTE: Fees include GST, monthly club newsletter sent by email, 4 x copies of the Oily Rag Magazine, discounted entry to HRCC race events and a joining pack for new members.
I, …………………………………..…. (Print name) hereby agree to abide by the rules of the Historic Racing Car Club (Qld) Inc.
Applicant’s Signature:
Date:
Enter all requested information in the fields provided, ensuring it is signed and dated. Send the completed form via either -
• email: jimg@jandwgoulden.com or
• mail: Membership Officer HRCC, PO Box 353, Red Hill Qld 4059 or
• hand to a committee member. If you require assistance in filling out the form please phone the Membership Officer on 0400 525 865.
☐ EFT: Westpac, BSB 034-001, Acct 229-793 (Reference “MS” and your surname)
☐ Credit Card: (Use page 3 of this form)
HISTORIC RACING CAR CLUB (QLD) INC.
MEMBERSHIP DEFINITIONS:
Category A Member (FULL)
A person who is actively involved in Motorsport, for example but not limited to, a competitor, an entrant or an automobile preparer. Category A – Full members are entitled to notice of general meetings and to attend, vote and debate at general meetings.
Additional Family person who wishes to be a Category A - Full member of the HRCC, resides at the same address as a current financial Category A - Full member and the family elect to received ONE service i.e. Newsletter, Oily Rag and Notices from the HRCC, may join at the reduced fee under Additional Family A - Full Member. The current member will be the primary member unless otherwise advised.
Category B Member (SENIOR)
A person who has ‘retired from motorsport’, i.e. not actively involved in motorsport as is a Category A Member. Category B Members are entitled to notice of general meetings and to attend, vote and debate at general meetings.
Category C Member (SOCIAL)
A person who wishes to participate in the social activities of the association and is not actively involved in motorsport as is a Category A Member. Category C Members are not entitled to vote or debate at general meetings.
Being a member of the Historic Racing Car Club (Qld) Inc. -
• Enables you to apply for Concessional Registration for any of your Classic Cars.
• Offers you the opportunity to participate in motor racing events either as a competitor or assisting in the running of events. A member discount is available for every event.
• Provides a forum for the exchange of technical information, literature, and spare parts so that historic racing cars can be preserved, restored, maintained, reconstructed and used in the best historic tradition.
• Provides you with the Club’s monthly newsletter which will keep you up to date on coming events, club news and items of interest
• Provides a representation of club members views and concerns to Motorsport Australia, the Historic Commission, Committees and Councils.
OFFICE USE ONLY
Membership No.
Payment Method:
Card Ordered:
Date Entered:
Historic Racing Car Club (Qld) Inc.
PO Box 353, Red Hill Qld 4059
Email: info@hrcc.org.au
Phone: 0424 321 072
Web: www.hrcc.org.au
Welcome Letter:
Remarks:
I, …………………………………..…. (Print name) hereby authorise the Historic Racing Car Club (Qld) Inc. to debit my Credit Card being for goods or services. (Details below) Amount $
Name on Card:
Card Holder Signature:
OFFICE USE ONLY
Membership No.: Banked Date:
Acct No.: Entered by: