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HONDA OWNERS CLUB - Northumbria Branch

MEMBERSHIP APPLICATION

 

 

Please complete and return to:-

 

HONDA OWNERS CLUB G.B.,

61 Vicarage Road, Ware, Herts, SG12 7BE

 

Your Details

PLEASE USE BLOCK CAPITALS

 

NAME: Mr/Mrs/Miss/Ms  ________________________________________________________

 

NAME: Mr/Mrs/Miss/Ms  ________________________________________________________

 

Children’s name(s) ______________________________________________________________

{under 16 covered by family membership}

 

ADDRESS: ____________________________________________________________________

 

_______________________________________________________________________________

 

POSTCODE: ____________________  EMAIL: ________________________________________

 

CONTACT TEL NO: _________________________  Mobile ____________________________

 

 

Model Currently Owned?   _____________________________________________

 

Year _______________

 

 

How did you hear about the Honda Owners Club? ______________________________________

 

 

Single Membership	£20.00
Joint Membership	£25.00

 

Golden Wing Magazine	FREE	FREE
Post & Packing		FREE
TOTAL		£

 

Enclose your crossed cheque/postal order for the TOTAL amount, payable to:

The Honda Owners Club (GB) or complete the credit card authority below.

 

VISA / MASTERCARD (delete as applicable)

 

Card No:  _____________  _____________  _____________  _____________  Expires:  ______ / ______

 

Name (as appears on card)  ______________________________________________________________

 

Signed:  __________________________________________  Date: ______________________________

 

I hereby apply for membership of The Honda Owners Club GB and agree to be bound by the rules of the Club

(a copy is sent with your membership card(s)).

 

Signed:  __________________________________________  Date:  ______________________________

 

Signed   __________________________________________  Date:  ______________________________

 

Joint & family membership provides Membership Cards and one copy of Golden Wing to the same address.

 

Data Protection Act “As a condition of the 1984 Data Protection Act, we must inform you that the efficient maintenance of membership records is dependant

 upon our keeping your details on computer under secure conditions.  Your signature on this form signifies your agreement to this condition.”