Online Membership Renewal Name*FirstLast Address* Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZambiaZimbabwe Country Phone* Email*Section 2 - Other Clubs Are you a member of other motorcycle organisations? If so, list the groups. (click Submit on the last page to finalise your renewal)__________________________________________________________________Section 3 - Motorcycle__________________________________________________________________BSA 1 Model* Engine No* Year* Frame No* Rego*FullOn Permit Roadworthy *OriginalRestored IncompleteBasket CaseBSA 2 Model(2) Year(2) Frame No(2) Engine No(2) Rego(2) FullOn Permit Roadworthy(2) Status(2) Select valueOriginalRestoredIncompleteBasket CaseBSA 3 Model(3) Year(3) Frame No(3) Engine No(3) Rego(3) FullOn Permit Status(3) Select valueOriginalRestoredIncompleteBasket CaseBSA 4 Model(4) Year(4) Frame No(4) Engine No(4) Rego(4) FullOn Permit Status(4) Select valueOriginalOriginalIncompleteBasket CaseBSA 5 Model(5) Year(5) Frame No(5) Engine No(5) Rego(5) FullOn Permit Status(5) Select valueOriginalRestoredIncompleteBasket Case(click Submit on the last page to finalise your renewal)________________________________________________________________________Renewal of membership of the BSAMCC of NSW Inc costs $30/year. Subscription is per calendar year. Fees may be paid in cash, direct deposit or cheque. Please make cheques payable to "The BSA Club of NSW".Post to: Membership Secretary, BSA Club of NSW, PO Box 4023, Homebush South NSW 2140Direct Deposit via your online banking may be made to: BSA Club of NSW, BSB 012559, Acct # 563879231. Please confirm below if paying by Direct Deposit and include name or membership number on bank transfer.The BSAMCC of NSW is not registered for GST therefore no GST is included in the fees. Click NEXT to go to Declaration and to complete the form. Direct Deposit ConfirmedI would like to renew my membership of the BSAMCC of NSW and by virtue of payment of the fees and confirming below I agree to continue to accept the conditions and regulations of membership as set out in the Club's constitution: Confirmation of agreement to constitution:*ConfirmedSubmitReset