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Membership Application / Renewal

I hereby apply for membership / renewal of the BRIGHTON & HOVE MOTOR CLUB LIMITED and in so doing agree to be bound by the Club's Memorandum and Articles of Association and Rules.

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New Membership or Renewal?*

New Application

Renewal

Your Details*

Title First Last

Membership Number (if renewal)

Address:*

Address Line 1 Address Line 2 Town/City County Post Code Country

Phone

Mobile

Email Address*

MSA Licence No.

Subscription to be paid

Full Membership = £20 p.a.
Joint Membership = £20 p.a. plus £5 p.a. per joint member

Note: If this is a 'Joint Membership' application (for spouses, partners and relatives at the same address) please enter names below.

Full Membership = £30 p.a.
Joint Membership = £30 p.a. plus £10 p.a. per joint member

Note: If this is a 'Joint Membership' application (for spouses, partners and relatives at the same address) please enter names below.

Number of Joint Members

Names of Joint Members

Total

Notes: The annual subscription provides valid membership for the period January 1st to December 31st.

If you wish to receive a copy of the Articles of Association please send a self addressed envelope of at least 23 x 16cm dimensions with minimum 75p stamp affixed to this address:

Brighton and Hove Motor Club
296-298 Madeira Drive Arches
Brighton, East Sussex, BN2 1EN

Payment Method*

I will pay by BACS

I will set up a Direct Debit

Other

BHMC Ltd
40-25-03
10183903

Name

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