MEMBERSHIP APPLICATION / RENEWAL

NAME _____________________________________________________

ADDRESS_______________________________________________________

_____________________________________________________

POSTCODE ___________________ TEL NO ___________________________

E-MAIL (Please write clearly)______________________________________________

Membership Fees for 2010 Junior *£25.00 (under 16 on 1/1/05)

Adult £ 5.00 (Non-racing)

Adult *£35.00 (Racing)

*A £12.00 discount will be applied to those who already have BRCA membership for 2010.

Annual membership fees are due on 1st November 2009

BRCA Membership Number (if applicable)________________

Crystals held 1. _______ 2. _________ 3.___________

Please tick box if you require a receipt.

I agree to be bound by the rules of the Ulster Model Car Club. I enclose fee of £ _____

SIGNED _______________________ DATE _____________________

NOTE : The committee reserves the right to refuse membership, or the renewal of membership where they see fit. The committee’s decision is final.