PEMC Application Form

If you wish to join the PEMC, please complete the details below and click on the "Submit" button. On receipt of your cheque (or standing order request), we will send you a "joining pack", comprising: your membership card and a recent copy of our monthly newsletter - Lineswapper.

Make Standing Order payable "Immediate" or a couple of weeks in advance.

Title: Surname(*):
First Name(*): Partner's Name:
Occupation: Date of Birth:
(e.g. dd/mm/yyyy)
Address(*): Home Tel(*):
Bus.Tel.:
Fax no.
Mobile Tel.:
 Post Code(*): E-mail address(*).

Introduced by: Main Bike:
(e.g. YAMAHA FAZER FZ1)
Second Bike:
(e.g. SUZUKI RM-Z450)

 

Please complete as many of the fields above as possible and note that in fields marked (*) we do require an entry please

Payment Details:


The annual subscription for year ending 31st March is:

  £35.00
and the joining fee is:  £5.00
Total:  £40.00

If you would like to pay future subscriptions by standing order, then click this box: and we will send you a standing order form to complete and return.

Please send a cheque for £40 made payable to PEMC, click this box if you are sending us a cheque and send it to the Membership Secretary at:

Ann & Roy Horne,
31B High Street,
Wappenham,
Northants
NN12 8SN

You will be enrolled as Member only on receipt of your cheque
or completed Standing Order Form.

Members' details are stored on computer disks for use only for the Membership List, Club Event attendances and for Club mailings. Please confirm that you have read the Club Constitution and will abide by it by clicking on the next box: .

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