Lincs Off Road

Membership Form

2010/11

This form is to declare that the person listed below has donated £20 to the Lincs Off Road Club, which entitles them to attend club events, receive news letters, use the website and vote on matters relating to the club.  Membership renewals are March.

First Name ..............................................       Surname.........................................

Address....................................................................................

        ………………………………………………………

Postcode...................................

Telephone..........................................         Mobile.................................................

Email.....................................................................

Vehicle......................................    Reg No………..........................

Sign ……………………..……………………….

Check list: [ ] I have filled in the form details above.

[ ] I have enclosed a signed Cheque for £ 20

Made out to ‘Lincs Off Road’

For official use                                                         Please return payment and form to:

The Membership Secretary

Membership No 80 Church Lane

Kirkby La Thorpe

Form Received    /    /                         Sleaford

Lincs

               NG34 9NU

Card Issue Date   /    /