Membership Application

I hereby apply to be considered for associate membership of M.A.D Freelanders. I agree to be bound by the current Rules and Regulations and to comply with the Codes of Conduct.
Date
Full Name
YOUR DETAILS
First name
Surname
Address
Post Code
Phone
Mobile
E-mail
Payment by -
Do you have any experience of driving off road? No/Some/Lots
How did you first hear about M.A.D Freelanders?
DETAILS OF YOUR VEHICLE
Model
Year
Reg. No
Do you have any modifications applicable to using the vehicle off road? Please specify:
Type 'MAD' here in capitals to confirm you are a real person (!)

Data Protection Act 1998

We intend to keep your membership details on computer. If you object to this, you should notify your objection in writing at the time of application. Your details will be used only for internal administrative purposes, and for effective running of the group.

May 2006