Lambretta Club of Great Britain

                     Membership Form

    Membership fees:- UK £20 per year - Overseas £25 per year

           PLEASE COMPLETE ALL PARTS IN BLOCK CAPITALS


NAME ___________________________________________________________

ADDRESS_________________________________________________________

________________________________________________________________

______________________________________POSTCODE__________________

COUNTRY_________________________________TEL_____________________


NAME OF YOUR SCOOTER CLUB_______________________________________

I ENCLOSE CHEQUE / INTERNATIONAL MONEY ORDER
MADE PAYABLE TO :-  L.C.G.B  To the value of £__________________

SIGNED________________________________  DATE____________________

                  PLEASE POST THIS FORM TO :-

                       Mark Pollard
                       5 Dulas Close
                       Redcar 
                       Cleveland 
                       TS10 2SJ


DATA PROTECTION ACT 1984 :- Please note that the information
provided will go on a computer database and be used for mailing
the club magazine. LCGB do not sell mailing lists or otherwise
pass on your details to any other organisation.
 

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