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MEMBERSHIP APPLICATION FORM

MY ALZA OWNERS’ CLUB (MAOC)

http://www.myalza.com_
Member Information
Full Name* : ___________________________________________________
Forum Nick Name* : ___________________________________________________
Gender* : [ ] Male [ ] Female
City/State* : ___________________________________________________
Contact No.* : HP -
Occupation* : ___________________________________________________
Ride Information
Registration No.* :

MAOC Management Use:

[ ] [ ] Date:
Approve Rejected ______________

Person In-
: ……………………………………………
charge

Position : …………………………………………..

Membership
: …………………………………………..
No.
Remaks :
Alza Transmission* : [ ] Automatic [ ] Manual
Alza Colour* : [ ] Classy Purple P14 [ ] Pearl White W16 [ ] Ebony Black 209
[ ] Medallion Grey S33 [ ] Glittering Silver S28 [ ] Ivory White W09
Order Information

T-Shirt Size &


Quantity :
___________________________________________________
(Black Colour Only)*

Car Sticker Colour &


:
Quantity* [ ] Black ____ [ ] White _____

Terms and Conditions

1. Please fill up all the details above as mandatory.


2. Members who not active will be discharge.
MEMBERSHIP APPLICATION FORM
MY ALZA OWNERS’ CLUB (MAOC)

http://www.myalza.com_
3. The committee reserves the right to distribute the
information for club use above as it sees fit.
4. The committee reserves the right to approve/decline
membership without giving any reasons.

* Mandatory

Signature

………………………………………
Name:

MAOC Management Use:

[ ] [ ] Date:
Approve Rejected ______________

Person In-
: ……………………………………………
charge

Position : …………………………………………..

Membership
: …………………………………………..
No.
Remaks :

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