Membership/renewal form – Club Alpine Renault

C.A.R. Ltd caters for owners and enthusiasts of the following Alpine cars:- A106, A108, A110, A310, R5T1 and 2, GTA, A610, A110 (2017), A290 and all sporting vehicles built in Dieppe or elsewhere under licence.

Application date(Required)

Application Type(Required)

Joining

Renewal

Membership number

(if renewing)

Name(Required)

First Last

Address

Street Address Address Line 2 City County ZIP / Postal Code Country

Primary Phone(Required)

Other Phone

Email address(Required)

Other family members applying (over 17)

Extra family member 1 Name

First Last

Extra family member 1 Email

Extra family member 2 Name

First Last

Extra family member 2 Email

(N.B. Family members enjoy the same rights and privileges as full members, including email newsletters, but do not receive copies of Club publications).

Length of membership(Required)

Full year (1 August to 31 July)

Half year (1 February to 31 July)

Late Year (1 June to 31 July following year)

FULL YEAR MEMBERSHIP RUNS FROM 1 AUGUST TO 31 JULY. / HALF YEAR MEMBERSHIP COMMENCES ON 1 FEBRUARY. / LATE YEAR MEMBERSHIP RUNS FROM 1 JUNE TO 31 JULY OF THE FOLLOWING YEAR (14 months’ membership). / RENEWALS MADE AFTER 1 NOVEMBER WILL BE SUBJECT TO A £5 SURCHARGE

Select Joining Fee (if joining)(Required)

Joining Fee (first year only) £10

Select full year fees (from 1 August to 31 July)

Full Year Membership £40

Select half year fees (from 1 February to 31 July)

Half Year Membership £20

Select late year fees (from 1 June to 31 July of following year)

Late Year Membership £40

Number of additional family members

£5 per person

Total

Vehicle details

Please give the model, year and reg number of your vehicle(s) below

Suggestion / comments

The Club Committee always welcomes members’ views on the running of the Club and in particular would welcome suggestions for events which could be of interest to the wider membership. Please indicate any suggestions/comments below.

(NB Your details will not be shared with any third party organisation for marketing purposes without your prior consent.)

Banking details for those who wish to pay on-line. Business Account name: CAR Ltd Sort Code: 20-08-64 Account number: 60656569 Payee Reference: Surname and initials NB – Please email the Secretary when you have made the online payment.