PLEASE PRINT AND SEND THE APPLICATION FORM AND REMITTANCE TO : MRS.TERESA GIBSON, 15 FAIRVIEW PARK, BOVEY TRACEY, NEWTON ABBOT, DEVON, TQ13 9PN OR RING 01626 830 325
APPLICATION FOR MEMBERSHIP

I APPLY FOR MEMBERSHIP OF THE EXETER AND DISTRICT BRANCH OF RELIANT OWNERS CLUB AND AGREE TO ABIDE BY THE RULES.
(BLOCK LETTERS PLEASE)

NAME...................................................................

ADDRESS ...............................................................

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EMAIL .................................................................

TELEPHONE NUMBER ......................................................

REG NUMBER ............................................................

YEAR AND MODEL OF RELIANT .............................................


I ENCLOSE A CHEQUE/POSTAL ORDER FOR 15.00 PAYABLE TO THE RELIANT OWNERS' CLUB : JOINING FEE 3.00 ANNUAL SUBSCRIPTION 12.00

MEMBERSHIP COVERS YOU AND YOUR SPOUSE/PARTNER AND CHILDREN UNDER 16 YEARS OF AGE.
PLEASE ATTACH A NOTE GIVING NAMES AND BIRTHDAY DATES OF CHILDREN UNDER 16 YEARS OF AGE .

SIGNED..............................................................

DATE................................................................

PLEASE SEND THE APPLICATION FORM AND REMITTANCE TO :
TERESA GIBSON, 15 FAIRVIEW PARK, BOVEY TRACEY, NEWTON ABBOT, DEVON, TQ13 9PN

INTRODUCED BY................................

MEMBERSHIP NUMBER