Military Vehicle Trust Membership Application Form

MVT MEMBERSHIP APPLICATION FORM - Please complete on SCREEN IN CAPITALS, print and sign

Office use only

Applicant	Title	First Name	Surname
Joint Family Member	Title	First Name	Surname
Full Postal Address

	County		Postcode Country if Overseas
Tel/Mobile	Tel:		Mobile:	Ex Dir ?
E-Mail	Use capitals we will convert to lower case
Please tell us how you found out about the MVT

Please give relevant details of any military vehicle you own. An example is given below. Please include as much information as possible, especially if the vehicle is rare or unusual. Please continue on a seperate piece of paper if necessary.-
Manufacturer	Model	Chasis type	Body Style	Payload Rating	Axle Layout	Country of Origin	Date of Manufacture
BEDFORD	QLR	LORRY	WIRELESS HOUSE	3 TON	4 x 4	GB	1943

Current Membership Rates are:		Complete as required
UK - Applicant and Joint Family Member living under the same roof.	£ 25.00	£
UK - Family Membership (only available to UK residents). Includes Applicant, Joint Family Member and all dependent children under the age of 18 living under the same roof. Please list dependent children and their date of birth on a seperate sheet.	£30.00	£
Europe - Applicant and Joint Family Member living under the same roof.	£35.00	£
Rest of the World - Applicant and Joint Family Member living under the same roof.	£40.00	£
One off joining administration fee applicable to all categories of membership	£5.00	£ 5.00
Total Membership Fee to pay	=	£

Please use ONE of the following methods of payment (preferably Direct Debit that helps reduce administration)
I/We wish to pay by Direct Debit (Please complete the Direct Debit Form and return with this Application Form
I/We enclose a Cheque/ PO made payable to the Military Vehicle Trust for £ being membership for one year
I/We wish to pay by Credit Card (Please complete the section below)

Card No.

Expiry Date		Valid From
Security Code (Last three number on the back of card)		Issue Number if your card has one

Name Printed on Card	CARD HOLDERS SIGNATURE ...........................................................................
Address of cardholder if different from above

I/We will abide by the constitution of the MVT and the Code of Conduct including the Basic Code of Conduct: "Members should not act prejudicial to the interests of the MVT, or bring the reputation of the MVT into disrepute. This includes any act involving any media communication in the public domain"

Signed (Applicant)............................................................................. Date

Signed (Joint Family Member) .......................................................... Date

Please return completed form and Direct Debit Form, if applicable, to:-
FREEPOST RRHJ-XSSA-AKKT
MVT MEMBERSHIP
15 St Leonards Road, Surbiton, Surrey. KT6 4DE

The MVT is a registered Company No. 2226906 Address:Graham Wuyts & Co.Virginia House, Station Road, Attleborough, Norfolk NR17 2AT