Application to become a Friend of
The Handlebar Club
FRIEND MEMBERSHIP APPLICATION FORM
 SHADED FIELDS ARE REQUIRED PLEASE 
YOUR NAME IN FULL
YOUR E-MAIL ADDRESS
PREFERRED FIRST NAME
or NICKNAME
ALLOW YOUR NAME & E-MAIL ADDRESS
TO BE SENT TO OTHER MEMBERS?
(LIST ONLY AVAILABLE BY MEMBER'S REQUEST)		 YES PLEASE NO THANK YOU
YOUR ADDRESS - Line 1
YOUR ADDRESS - Line 2
CITY
COUNTY or STATE
POST CODE or ZIP   AGE  
COUNTRY
NATIONALITY
HOME TELEPHONE NUMBER
INCLUDE INTERNATIONAL PREFIX IF OUTSIDE THE UK
MOBILE/CELL NUMBER
BUSINESS PHONE
OCCUPATION
PROPOSED BY
IF KNOWN BY A CURRENT MEMBER
CLUBS, SPORTS, GAMES
INTERESTS AND OTHER ACTIVITIES
PREFERRED PAYMENT METHOD PayPal CHEQUE / PO

If you would like to appear in our Friends Photo Gallery,
you are invited to e-mail a recent photograph of yourself
to our Secretary, .