Derby Lightweight Preservation Group membership application form

As a member of the DLPG you will receive the quaterly newsletter "Pioneers". Please print out this form and send it with your remittance (cheques made payable to the DERBY LIGHTWEIGHT PRESERVATION GROUP) to:-

David Gilbert
Membership Secretary
1 Loombe Close
Swanton Morley
NORFOLK
NR20 4NW

SAE appreciatted. Please do not send cash through the post.

I / we wish to become members of the Derby Lightweight Preservation Group

Title :
Full Name :
Address inc. Postcode :
 
 
 
Tel no :
Signature :
 
Subscription (year ending 30th April)
Ordinary   £10 ________
Family   £10 ________
School   £10 ________
Optional donation :     ________
TOTAL :   ________

IMPORTANT NOTICE - DATA PROTECTION ACT, 1984

The DLPG membership records are on computer for the ease of producing address labels. The records are used solely for internal administration and will not be disclosed to unauthorized persons under any circumstances. Please tick below only if you object to you records being held on computer.

 

Membership shall be at the discretion of the DLPG