2010  Membership Application

First Name:

Surname

Post Code

Email:

Home Phone:

Mobile (Text):

 

Address:

Class:

Machine

Capacity

Preferred race No.(s)

Sponsor/Team

Please tick box if you are happy for us to keep your details on computer. Your details will not be passed onto any other party and will only be used by SCEC to contact you directly about club events.
Licences Held
ACU
AMCA
Other
Please note that Champ/Expert/Vets/Ladies class