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MEMBERSHIP RENEWAL FORM

> Click here if you need to apply for a new membership

 

Membership Renewal:

Full Name:

Forum User Name:

Membership Number:

Any new additional information needed for database?

eg - changed address? new email address? new engine fitted? registration plate change? 

 

Membership Status:

Membership level required.

1 year Rallye Register membership renewal @ £16   

2 year Rallye Register membership renewal @ £28   

3 year Rallye Register membership renewal @ £36   

Payment Options. Please tick how you would like to pay for your membership

Cash or Cheque   

Credit or Debit card via PAYPAL   

Payment Information: To pay by cash or cheque, please print out this order form and send with your payment to 106 Rallye Register, 15 Hameldon Road, Rossendale, LANCS. BB4 8RL. If sending cash please send by registered post. If paying by cheque, make it payable to "106 Rallye Register"

To pay by credit card or debit card via PAYPAL our online payment system, please tick the PAYPAL option above and click submit where you will then be directed to our online payment page to complete your application.

Any questions regarding this form or payment please email webmaster@106rallye.co.uk

 

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