CITROEN SPECIALS CLUB
MEMBERS' INFORMATION UPDATE FORM
| Membership Number | |
| Surname | |
| First Name | |
| Joint Member (spouse/partner/co-builder/co-driver) |
|
| Telephone | |
| Mobile or Fax Number | |
| E-mail address | |
| Website URL (if any) | |
| Postal address | |
| Postcode | Type of car (Make and Model) |
| Colour | |
| Registration number | |
| Donor | |
| Name of car (if any) | |
| Other
information: (e.g. Modifications or changes from norm.) |
|
| Car
built by: (this information is for our records and will not be published) |
|
| car
bought from - if applicable (this information is for our records and will not be published) |
|
| Help offered: please check all applicable | |
| A: Assistance with minor repairs | B: Tow to a garage |
| C: Have (or can obtain) spare parts |
D:
Can arrange accommodation IN AN EMERGENCY! |
|
E:
Languages Spoken (please also specify opposite) |
|
|
I am willing to be on a list of members able to help others with their build. |
|
|
This information is used for Citroen Specials club purposes only and may
be stored in a computerised system. If you DO NOT OBJECT to your details being stored in this way,click on send form.
|
If you DO OBJECT to your details being stored in a computerised system please clear form and contact the Membership Secretary direct. |