MEMBERSHIP APPLICATION FORM 2011
Please complete this form and send it to:Max Walter
Membership Secretary
GT40 Enthusiasts Club Ltd
Oak Lodge E-mail address: membership@gt40enthusiastsclub.com
113 Wimborne Road West
Wimborne
Dorset
BH21 2DH
UK
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Name:........................................................ |
I wish to pay my subscription of £30:
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Address..................................................... .................................................................. |
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Switch/Maestro only) Number:........................................................ Start Date:.................... Expiry Date: .................. Issue No: ...... Card CVS No (Last 3 digits):....... |
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Membership Number:................................ |
Signed................................................................................... Date...........................................
Useful Information
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Phone: |
Home......................................................................... |
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Work......................................................................... |
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Fax............................................................................ |
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Mobile....................................................................... |
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E mail Address |
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Occupation |
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Specialist Skills |
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OFFICE USE D’base Entry ........................... Starter Pack....................... B/S No....................
WEBSITE
GT40 ENTHUSIASTS CLUB LTD
CAR DATA FORM
Please complete this form for our records.
The Club is keeping an historical record of cars in the Club. It would be helpful if you would send some photos for the book when returning the form. They can also be e-mailed direct to TimGT40Club@aol.com.
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Name:................................................................................ Membership No:............................ |
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Chassis Make e.g. GTD/KVA/TORNADO/RF |
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Bodyshell Make (as above) |
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Type: MK 1,2,3,4 |
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Colour Scheme |
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Engine (brief specification) |
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Gearbox (make & type) |
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Carburettor/fuel system |
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Wheels (make, size & type) |
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Tyres (make, size & type) |
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Accessories e.g. Air conditioning |
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Build Started |
................................. Completion date............................. |
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Will your car be on the road in 2011?................................ |
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Build cost or purchase price |
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Registration Number |
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Please put a ring around the area you consider you live: |
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1. Berks/Bucks/Ox/Hants |
6. North East |
11. Western |
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2. Essex |
7. North West |
12. Yorkshire |
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3. East Anglia |
8. South Coast |
13. Scotland |
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4. London & SE |
9. South West |
14. Overseas |
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5. Midlands |
10. Wales |
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Data Protection Act 1998
The information you have provided on this form will be stored on the Clubs
membership database, which will be circulated to members during the year. It
will not be sold or passed |
