WOLSELEY HORNET SPECIAL CLUB – MEMBERSHIP APPLICATION FORM
Please complete the form below and return it, with your remittance, to the Secretary:
Brian Thrussell, Wayside Cottage, Church St, Upton Grey, Hampshire , RG25 2RA, UK
N
ame : …………………………………………..…………… Address………………………………………………………………………………………….. Postcode : …………
Telephone
: Home ………………..….……. Work : ….……..……..……… Fax : ………..…..………… E-mail :.……………………………..…………………If you have been a member of the WHSC in the past, it would help us to know your original membership number : No
…/………All new members will receive a copy of the current Club Magazine. Please complete the section below :
Item |
Qty |
Price |
Item |
Qty |
Price |
UK Membership, p.a. £25 |
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Overseas Membership (Eur) £30 |
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Overseas Membership (ROW)£35 |
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Carried forward |
£ |
£ |
I enclose a cheque /Postal Order payable to the Wolseley Hornet Special Club to the value of £ ………………
OVERSEAS MEMBERS : Please send cheques in sterling, drawn on a UK bank.
I have read and agree to abide by the Club Rules and Regulations.
Signed : ………………………………………………………….. Date : ……………
Our membership list is held on computer. If you do not wish your name to be added to this database, which is used for mailing purposes only, please tick the box, but remember that this makes it more difficult for us to ensure that you receive regular communications from us.
[ ]CAR DETAILS
To be completed by new members for the Club Registrar. Please advise the Registrar of any change of vehicle or new purchase for the Club Register. To assist the Registrar, it would be appreciated if you would complete and return the section below, even if you do not wish to join the Club at the moment.
I purchased this vehicle on …………………………………Registration No. ……………………………………………..
Date of first registration …………………………………….Car Number ………………………………………………….
Chassis Number …………………………………………….Engine Number ……………………………………………...
Original Engine Number ……………………………………Description / location of coachbuilder plates (if any) ....…
…………………………………………………………………Coachbuilder ………………………………………………..
Model …………………………………………………………Description / colour of coachwork ………………………...
……………………………………………………………………………………………………………………………………
History / other points of interest ………………………………………………………………………………………………
…………………………………………………………………
Photograph enclosed / to follow (Delete as applicable)