MEMBERSHIP APPLICATION
The Leyland Society

      Please print out this form (portrait), fill it in and send, with remittance, to:
                 David Bishop
               "Sunnyside"
                 Whitchurch Road
                 Aston, Nantwich
                 Cheshire
                 CW5 8DB               (Please make cheques payable to "Leyland Society Ltd.")

On receipt of your form, you will be sent a package containing your membership card, vehicle registration form (vehicle owners) and where available, back numbers of  'Leyland Torque' to the begining of your subscription year.

Forenames    ..............................................................................................................................
Surname      ..............................................................................................................
Address       .....................................................................................................................................
                    .....................................................................................................................................................
                    .....................................................................................................................................................
                    ..................................................                              Postocde........................................
Telephone No...................................................................................................

Date of birth (Optional)  .............................

Your Main Interests (Please Ring):
           Leyland Vehicle Owner                  YES / NO
           Employee / ex-employee                YES / NO
           Interested in:         Buses           Lorries          Fire Engines          Everything Leyland
           Periods of interest:          1896 - 1927           1928 - 1945             1946 - 1968              1969 to date
           Can you contribute Articles or Photographs for the Society Magazines?            YES / NO
           Other special Leyland interests............................................................................................................

Vehicle Owners : If you do NOT wish us to disclose your vehicles details to other members,
                      please indicate with an 'X' .....
Members : If you do NOT wish us to disclose your address and/or telephone number to other members,
                     please indicate with an 'X' .....

I hereby apply for membership of the Leyland Society for the period to 31st July next,
and enclose my remittance for £............... (If joining after 1st April, your subscription will last until July in the following year.)

Membership  -  UK £20.00 (Family £23),  EEC £24 (Sterling), or by PayPal £26;  Overseas: (outside EEC) £28 (Sterling) or by PayPal £30

I agree to be bound by the terms of the Memorandum & Articles of Association together with the Bye-laws of the Society (for a copy, please send a large S.A.E to the Membership Secretary) or other regulations which may be made by the Committee. The Leyland Society is a company limited by guarantee - The Leyland Society Ltd. (Registered office: 'Valley Forge', 213 Castle Hill Road, Totternhoe, Dunstable, Beds, LU6 2DA). Registered in England No. 4653772.

Signed.............................................................................................  Date............................