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WEST DORSET VINTAGE TRACTOR & STATIONARY ENGINE CLUB LIMITED

Company Number 6560981

MEMBERSHIP APPLICATION / RENEWAL FORM 2012

NAME .....................................................................................................................................................

ADDRESS.............................................................................................................................................

.................................................................................................................................................................

...........................................................POST CODE.......................................................

TEL. NO.  ....................................................................................................................

PLEASE COMPLETE THE FOLLOWING PARAGRAPH

I wish to apply for / renew (delete as applicable) membership of the West Dorset Vintage Tractor & Stationary Engine Club Limited for the year ending 31st January 2013.

I enclose payment of £14.00 single adult        £15.00 family couple     £1.00 child under 16    (delete as applicable)

CHEQUES TO BE MADE PAYABLE TO:  WDVT & SE CLUB LTD

Signature....................................................                           Date.................................

Please return signed & dated  application form with your remittance to:  IAN THOMPSON, MEMBERSHIP SECRETARY, 2 GATCOMBE CLOSE, DORCHESTER, DORSET, DT1 2AW

TEL.     01305-265309

If membership card is required immediately please enclose stamped addressed envelope

otherwise your membership card will be forwarded with the next available newsletter

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