PEMC Application Form

We are pleased you have decided to join us, please complete the details below and click on the "Submit" button. On receipt of your subscription, we will send you your membership number and "joining pack".

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

Where / how 
did you hear about us? (*):
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 subscription for period ending 31st March 2018 is:

 £25.00
and the joining fee is:  £5.00
Total:  £30.00

We would prefer you to pay your subscriptions by Standing Order.

To do this, please click HERE to access the Standing Order and print it. Then, please complete it (NB it is important to enter your name in the reference box after the PEMC Account Number, so that we can identify your payments) and send the completed Standing Order to your bank.

This Standing Order covers the money due now and also the annual renewal when next due. Remember, standing orders are totally under your control, unlike Direct Debits.

Please click here if you are completing a Standing Order to pay your subscription.

Alternatively, if you prefer to pay by cheque, please send a cheque for £30.00 to the address below, made payable to PEMC and click this box :

Alison Thomas

Preston Barn Farm, Levedale Road

Dunston, STAFFORD

ST19 5RB

You will be enrolled as Member only on receipt of credit in our bank from your Standing Order or receipt of your cheque.

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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