ECMC Membership Form

Eastern Counties Motor Club

Membership Application Form

I hereby apply to become a member of Eastern Counties Motor Club Limited and if elected I undertake to abide by and be bound by the Memorandum and Articles of Association and Bylaws of the club.

Name *

Prefix First Name Last Name

Address *

Street Address
Street Address Line 2
Town/City	County
Post Code	Country

Phone

Mobile *

Date of birth

required for under 18's only

E-mail *

Minimum Ages:

Road Rally Navigator: 12, Stage Rally Navigator: 16, Sporting Trial Driver: 16, Production Car Trial Driver: 15, Production Car Trial Passenger: 12, Production Car Autotest Driver: 12, Autotest Driver: 16, Circuit Racing: 16, Minicross: 14; Autocross Driver: 16, Sprint Driver 16

Anything else requires a full RTA license

Other motor club memberships

Car(s) owned

Membership Type *

To be eligible for Family Membership, all family members must live at the same address. Please complete this form for other family members who require a membership card, selecting the type as "Additional family member"

Payment Method *

BACS - Transfer to 30-64-22 30252860, please use "ECMC [your name]" as the payment reference Cheque - payable to "Eastern Counties Motor Club Ltd" N/A - Additional Family membership

If paying by cheque, please send it with a covering note to:

ECMC Membership Secretary, Canes Farm, Burstall, Ipswich, Suffolk, IP8 3EA

Data Protection Act: Members details are recorded electronically for mailing purposes, no other use will be made of this data.

A company limited by guarantee. Certificate of incorporation: England, Number 510701
Founded 1950, Royal Automobile Club Motor Sports Association Ltd, Affiliation Number 48.
Registered Office: 5 Dales Court, Ipswich, IP1 4JR.
President: R J Smith Vice-presidents: G Morley, B Baker, F Porter

www.ecmc.co.uk