THE FAIRTHORPE SPORTS CAR CLUB
FAIRTHORPE   TURNER  ROCHDALE  TORNADO ASHLEY   FALCON   EB  HISTORIC SPECIALS
MEMBERSHIP APPLICATION FORM
Please complete this form and return it with your remittance to
Membership Secretary
9 Lynhurst Crescent, Hillingdon, Middx UB10 9EF, UK

I/We* the undersigned with to APPLY FOR/RENEW* Membership of the above Club for the twelve months/5years* to 30th April                    (Please enter year)     (*delete as applicable)

Name(s)     *Mr/Mrs.   ..................................................................................
Names(s)    *Mr./Ms.  .................................................................................
Address                              .................................................................................
                                                  .................................................................................
                                                  .................................................................................
                                                  .......................................................... Post Code ..............................
Tel. No. (Home)               .........................................Email Address ........................................

DETAILS OF CARS

Make ...............................................................     Model ..............................................................
Registration No. ...........................................     Year of Registration ...............
Chassis No. ....................................................     Engine Type ....................................................
Capacity ........................................................     Other Information .........................................

If you want details left off the Computerised List please tick here        
Are you prepared to show your car at Exhibitions ?    YES   NO

MEMBERSHIP FEES

UK £17 p/a or £85 for 5 years  
*Overseas Surface/Europe £19 p/a or £95 for 5 years
Euro: 38 p/a or 190 for 5 years
US$36 p/a or US$180 for 5 years
 
*Overseas Airmail £22 p/a or £110 for 5 years
US$42 p/a or US$210 for 5 years
 
 
TOTAL ENCLOSED
 

Please make cheques payable to
FAIRTHORPE SPORTS CAR CLUB                  Signature ............................................................

*Overseas members:  International Money Order or Eurocheque in Steriling
US $36 (Surface) or US $42 (Airmail)