MEMBERSHIP APPLICATION FORM
MEMBERSHIP APPLICATION FORM
Membership is open to anyone with an interest in Motorsport.
Complete in BLOCK CAPITALS; if sending by fax, use black ink.
Mr/Mrs/Ms/Miss
Surname Initials First Name____________________
Address __________________________________________________________________
___________________________________________________________________
Postcode __________________________________________________________________
Telephone Work/Mobile______________________________
EmailAddress________________________________________________________________Please give details of the types of Motorsport of interest to you:
___________________________________________________________________________
Are you prepared to help with the administration of the club? YES / NO
METHODS OF PAYMENT
1 Please enclose a cheque for your subscription, made payable to: REDDITCH AND DISTRICT CAR CLUB.
2 Or by credit Card
I authorise the Redditch and District Car Club to debit the subscription from my Visa/MasterCard number
Expiry Date ______________________________ now and in each year when due.
3 Or by Bankers Order
To Bank plc, Account No.____________________________
Full address of Bank_________________________________________________
__________________________________________________________________
Please pay Barclays Bank plc. LEICESTER, LE87 2BB. [20-48-08] for the credit of Redditch and District Car Club account number 70058351, the sum of £_________, and debit my account accordingly, now and on the first day of January in each subsequent year until cancelled by me in writing. Please ensure that you quote this reference [membership number] when making payment. Signed I hereby apply to become a member of Redditch and District Club in accordance with its constitution and rules and confirm the method of payment detailed above.
Signed Date_______________________________
In all cases please return the form to: R.D.C.C. c/o CYRIL LOMAN, 54, Ettington Close, Wellesbourne, WARWICK, CV35 9RJ...
MEMBERSHIP FEES: - Family £19.00 Single £16.00
Junior (under 25) £10.00 Marshall £10.00
11th December, 2006