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CLWB LAND ROVER GOGLEDD CYMRU - NORTH WALES LAND ROVER CLUB
MEMBERSHIP APPLICATION FORM 2015
I wish to apply for membership of the North Wales Land Rover Club and enclose the Membership fee(s) of
£20 (Full Member) or £5 (Associate).
Please make cheques payable to North Wales Land Rover Club.
Forename………………………………. Surname…………..…………….. (the name that you wish to be known by).
Address……………………………………………………….…………………………………………........……………….
………………………………………………………………………………………………………......……………………..
Post Code…………………………………...…..
Phone No.(s)………………………………………………..………..
Member’s Signature…..………………………...
Email address…..………………………………………….…………
Full Member - I wish to receive my own newsletter (Dragon’s Drivel)?
YES / NO
Help the Club and read your Newsletter electronically as a PDF. This saves on postage and printing costs for the
Club and it's a greener way to get your updates on Club activities. (You must provide an email address above so
that we can notify you when the next issue is out.)
Any Member: Get your newsletter electronically?
NO
YES /
Associate Members to the above Full Member:
1. Forename……………………….Surname…………..…Date of Birth (if under 18) ………………
2. Forename……………………….Surname…………..…Date of Birth (if under 18) ………………
3. Forename……………………….Surname…………..…Date of Birth (if under 18) ………………
Have you been a Member of NWLRC before? YES / NO
If YES, Membership No………….……
I agree to keep the rules and constitution of the North Wales Land Rover Club Ltd.
Applicant’s Signature…..…………………………
1. Associate’s Signature…..…………………………
2. Associate’s Signature…..………………………. 3. Associate’s Signature…..…………………………
Signature of Parent /Guardian if Under 18: …..…………………………
Vehicle Type (Circle):
Defender,
Discovery,
Series 1,2,3,
Range Rover,
Freelander
Please indicate events of interest to you:
Social Evenings
Camping / Caravanning
Green Lanes
Trials
General Motoring
Any Other Suggestions:………………………………………………………….……………………
…………………………………………………………………………………………………………
How did you hear about the North Wales Land Rover Club? ………………………………….…….
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Please return this form to: David Lewis: Pen y Felin, Rowen, Conwy LL32 8TS
01492 650004. Email: [email protected]
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