Application to become a Full Member of
The Handlebar Club
FULL MEMBERSHIP APPLICATION FORM
 SHADED FIELDS ARE REQUIRED PLEASE 
YOUR NAME IN FULL
YOUR E-MAIL ADDRESS
PREFERRED FIRST NAME
or NICKNAME
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

Please note that if you are unable to meet the committee in person, we shall require a recent photograph to prove that you have the required qualification. Please send it by e-mail to our Secretary, .