Accrington Motor Sport Club Membership Application Form

Accrington Motor Sport Club Membership Application Form

I/We wish to apply for membership of Accrington Motor Sport Club until 31st December 2021.
Name of applicant *

First Name Last Name
Please tick

I am over 18 I am in full time education
Name of partner (joint application)

First Name Last Name
Names of any children under 17

First Name Last Name
Names of any children under 17

First Name Last Name
Names of any children under 17

First Name Last Name
Address *

Street Address

Street Address Line 2

Town County

Post Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
DATA PROTECTION ACT

In accordance with latest GDPR we will not pass on any of your personal details to a third party. For admininistrative purposes the information you provide will be stored on a computer database; by submitting this form you are consenting to us holding this information.

Subscriptions: SINGLE £5.00 JOINT £10.00 (includes all children 17 & under).

You can pay by BACS transfer using sort code 30-90-87 and account number 02435410.

Alternatively you may send a cheque made payable to Accrington Motor Sport Club and post to Mrs Tracey Smith, Membership Secretary, 5 Grafton Gardens, Accrington, Lancashire, BB5 2TY.

Thank you for supporting Accrington Motor Sport Club.
Additional Information
Please write any notes or comments for the membership secretary here.
Should be Empty: