First Name:

Surname:

Address:

Post Code:

Email Address:

(Required for members area)

Home Phone No:

(Optional)

Mobile Phone No:

(Optional)

Membership Fees:

Please tick as appropriate   1 Year £15.00   5 Years £60.00

I would like to become a member of The Class 37 Locomotive Group and enclose a cheque/PO for the sum of £........ Inclusive of a donation of £........ (optional) made payable to The Class 37 Locomotive Group.

Signed:

Date:

Please send this form to:
Membership Secretary
Class 37 Locomotive Group
2 Clifford Drive
Oulton Broad
LOWESTOFT
Suffolk
NR33 9EU

DATA PROTECTION ACT
As part of the Data Protection Act, Please be advised that some of the information given on this form will be held on computer file. The information is for group purposes ONLY and no details will be given to any third parties.