Victorian Update Form

You must enter your membership number (printed on your membership card) and enter the new information in the appropriate fields.

Please fill in the details of your motorcycles that are registered through the CIMAA club permit scheme. It is our legal requirement to maintain a database of registered vehicles. You can list multiple registrations in the form field as:

Make    Model      Year of Manufacture       Registration Number        Expiry Date
Make    Model      Year of Manufacture       Registration Number        Expiry Date

Please use your postal address to allow delivery of the Membership Card. If you use a Post Office Box number enter it in the “Street” field.

You may leave fields blank if your information has not changed.

Membership Number:

First Name:


Last Name:

House # and street:

City:

State:

Post Code:

Home Phone:

Work Phone:

Mobile:

Email Address:

Eligible Motorcycles Currently Owned (not registered by CIMAA):

Motorcycles currently registered by CIMAA (Make/Model/Year/Registration/Expiry)

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