Period of membership:
First names:
Surname:
Number/name & street:
Other address:
Town:
County:
Postcode:
Country (if not UK):
Home phone (inc area code):
Mobile phone (no spaces):
E-mail address:
Vehicle make/model
Registration number
Vehicle modifications from standard (winches, difflocks etc)
Vehicle class (if known)	Standard Intermediate Modified
T-Shirt size (if included)	S  M    L  XL  XXL

Choose membership type Full membership ( Crewman/Social membership Occasional Crewman (no T-shirt)

£25 £15   £8

With your agreement, we'd like to put a list of members names and membership numbers on the CSW website.  This will help organisers to validate memberships before an event, thereby removing the need to check membership cards on the day.  Please untick this box if you are NOT happy to have this information on the website.  No further details will be shown so the information is of no use to anyone else!