VSCC of WA - LOG BOOK APPLICATION FORM

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					                      Vintage Sports Car Club of Western Australia inc - www.vsccwa.com.au


              VSCC of WA - LOG BOOK APPLICATION FORM

Applicant name:_________________________________________________________

Address: _________________________________________________Postcode:_____

Phone: _______________ (w) __________________ (h) ___________________ mobile

Fax: __________________ Email: ____________________________________

VSCC Membership No: ______________________


Signed: __________________________________                  Date: _____________



OWNER DETAILS:

Name: _________________________________________________________

Address :___________________________________________________ Postcode: _____

Phone: __________________ (w) ________________ (h) __________________ mobile

Fax : ____________________            Email: _______________________________




                                         Vehicle Categories:

                                    J      Vintage Cars                            Pre 1931
                                    K      Post Vintage                            1931 to 1940
                                    Lb     Historic Racing & Sports Cars           1941 to 1960
                                    Lc     Production Sports Cars                  1941 to 1960
                                    M      Historic Racing & Sports Cars           1961 to 1965
                                    Na     Production Touring Cars                 Pre 1958
                                    Nb     Touring Cars                            1958 to 1965
                                    Nc     Touring Cars                            1966 to 1972
                                    O      Historic Racing & Sports Cars           1966 to 1969
                                    P      Formula 5000 Racing cars                Pre 1978
                                    Q      Historic Racing & Sports Cars           1970 to 1977
                                    R      Historic Racing & Sports Cars           1977 to 1985-87
                                    Sa     Production Sports Cars                  1941 to 1960
                                    Sb     Production Sports Cars                  1961 to 1969
                                    Sc     Production Sports Cars                  1970 to 1977
                                    Modern Production Sports Cars                  after 1977
                                    Modern Historic Racings Cars                   after 1985 – 87
                                    Modern Sedans                                  after 1977




Filename - VSCCWA-Log-book-application.doc   Last document revision - 18/10/2007      Page No. 1 of 2
                      Vintage Sports Car Club of Western Australia inc - www.vsccwa.com.au



               VSCC of WA - VEHICLE DESCRIPTION FORM


VEHICLE DETAILS:

Make of car: ______________________                           Model : __________________

Type / Identification: ________________                       Year of Manufacture : _______

Chassis number: ___________________                           Civil Registration # _________

Construction material: _______________                        Colour: __________________

Year of youngest major * component: _____                     Component: ______________

CAMS Historic Group __________________                        Other: ___________________


    •    Major components are: body / chassis unit, engine, brakes, gearbox, rear axle casing or
         inlet (i.e. carbs, blower, turbo)

    •    Please attach any supporting relevant vehicle documentation to this form



ENGINE DETAILS:

Make: _______________________________                         Configuration:__________________

Engine Number (s) __________________________________________________________

No. of cylinders: _________                                   Actual swept volume in cc _______

Bore _______________ mm                                       Stroke _____________ mm

Supercharged / Turbo       (please circle)                    Resultant engine capacity : _______cc

Valve location / actuation: _____________


ELIGIBILITY OFFICER’S COMMENTS:




LOG BOOK NUMBER: _______________                              FIRST ISSUED ________________



Filename - VSCCWA-Log-book-application.doc   Last document revision - 18/10/2007   Page No. 2 of 2

				
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