O.R.V.C APPLICATION FORM.
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Please complete this form and bring it along to
a General Meeting
O.R.V.C APPLICATION FORM. |
APPLICANT
First Name:_____________________ Surname:______________________________
Date of Birth:_____/______/______ (optional)
Partners’s Name_______________________________________________________
Date of Birth:_____/______/______ (optional)
Residential Address:____________________________________________________
_____________________________________________________________________
Postal Address (if different):______________________________________________
_____________________________________________________________________
Phone Number Work (____) _______________ Home (____) ___________________
Fax (____) ______________ Mobile _____________________________________
E-mail:________________________________@_____________________________
VEHICLE DETAILS
Make/Model:________________________________ Reg. no.:__________________
Insurance Type (Comprehensive, 3rd Party):__________________________________
FAMILY APPLICANT
Children and Age (optional):______________________________________________
____________________________________________________________________
Wedding Anniversary:____/_____/_____ (optional)
Are you a Member of another club:________________________________________
If so which is your home club:____________________________________________
IT IS MANDATORY that any vehicles attending a club event be registered, roadworthy and have a minimum of third party property insurance at all times. In submitting this application a potential member agrees to the afore-stated conditions.
Sign:____________________ Dated:_____/______/____