MEMBERSHIP APPLICATION FORM
here if you need to renew current membership
Date of Birth:
Full Address &
This is essential for sending
out your membership pack!
Haven't registered on forum yet
What car do you own?
Only UK Rallye owners need to
complete the following questions - Please have your V5 logbook in front
of you when filling in the form, incomplete forms will NOT be accepted
and will just delay your membership application. Please note this
information is essential for inputting your car details into the Rallye
Register database and finding your import number. It is strictly
confidential and in no way will be passed to any other 3rd party.
What Rallye do you own?
Series 1 1.3 8v
Series 2 1.6 8v
Series 2 1.6 16v (non UK)
Series 1 16v Conversion
Series 2 16v Conversion
Exact date you acquired your Rallye:
Please state DD/MM/YY. Date is found on logbook
Full Registration Number: Found on logbook
Exact date of first registration: Please
state DD/MM/YY. Date is found on logbook
What colour is your Rallye?
Other colour please state
Peugeot dealer who sold the car new? Only
answer if you know for sure!
Chassis/VIN Number: Found on the
Engine Number: Found on the
How many previous owners? Found
on the logbook.
Postcode your Rallye is currently
registered to? Found on the logbook.
Postcode of previous
owner? Found on the logbook. This is essential information
needed to find your import number
Standard factory optional extras fitted
when car was bought new. PAS applies to S2 Rallyes only. Sunroof
available on S1 Rallyes only. Airbag in the steering wheel indicates
the car has got PAS.
Power Assisted Steering (PAS)
Factory Fitted Sunroof
Modifications: Please give
details of any modifications your Rallye has. You don't need to go into
too much detail if you have lots!
Membership level required.
1 year Rallye Register
membership @ £22
2 year Rallye Register
membership @ £36
3 year Rallye Register
membership @ £45
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.
regarding this form or payment please email