THEFRAZER NASHCARCLUBLTD

MEMBERSHIPAPPLICATION

Surname: …………………………………………………………..Title: ……………..Forename/s: …………………………………………………………………………….and/orhow wouldyou like to be known?: …………………………………………….PostalAddress: ………………………………………………….……………………...

……………………………………………………………………………….………….

…………………………………………………………Postcode:………………...... Tel:Home:…………….…………....….. Business: …….………………..….…...…..Mobile………………………...... Fax:………….…………..……….……..E-mailaddress:…………………………………………………………….….………...1Date of Birth(if under 30 or optional):……………Occupation:……..…..………......

Name of Partner(if alsoapplying for Family Membership)………...………….………………...Haveyoupreviously been aMember of the Frazer NashClub orSection?Yes/NoAre you a member of any other motoring club? Yes/NoIf so please state Club: ………………………………………………………..………..

Frazer Nash and GN carsowned - please give model(s),registration number(s)and chassis number(s).

…………………………………………………………………………………………..

…………………………………………………………………………………………..Previous owner/s: ………………………..………………………………..………..…..

/over …

1Youremailaddressandanyotherpersonaldetailsincludingyourname,addressandtelephonenumberwillbestoredasanelectronic database or in our manual records in accordance with our obligations under the Data Protection Act 1998.

A listof Club Members is published and extracts may appear from time to time in other Club publications.The information will not bepassedtoanyexternalbodiesorthirdpartiesotherthanifrequiredbylaw. UnlessyouadvisetheClubtothecontrarywewillassume that we have your consent to store and publish this information in accordance with the above.

V5 Revised 20.03.15

Type of membership applied for:-FULL/ASSOCIATE/ FAMILY/JUNIOR (under 30)

Please delete where appropriate.

Ienclose mycheque as below2:-

£5.00 Entryfee£5.00

not payable by Junior members

£25.00 Subscription (Full orAssociate)£

£12.50Subscription (Junior)£

under 30 years of age

£32.00 Subscription (Overseas, including airmail)

Sterling cheques only please, drawn on a UK bank£

or other method by specific arrangement

£3.00 Subscription(Family)

Proposedandpartneratthesameaddress.£

Total£

I agree to accept a liability of not exceeding £1.00 should the company be wound upthrough insolvency.

If accepted as a Member, I agree to abide by the Rules and Byelaws of the Club.Signed: …………………………………………………… Date: ……..…………….

I agree to receiveelectronic and/or websitecommunications from the Club.

Mye-mail address is: ......

Signed: ...... Date:...... 3

Print name:......

CHEQUES TO BE MADE PAYABLE TO THE FRAZER NASH CAR CLUB LTD. For Overseas members payment by bank transfer or PayPal is also possible.

Pleasereturnto:-IanMaxwell,CompanySecretary,FrazerNashCarClubLtd, ThornHanger,TheCommon,Marlborough, WiltshireSN8 1 DL.Tel.01672 513536 E-mail:

2TheMembershipyearrunsfrom1stJanuarybutMembersjoiningafter30thSeptemberarepaidupuntil31stDecemberofthefollowing year. Membership subscription fee is not refundable.

3Provisions of the Companies Act 2006 which came into force in January 2007 enable companies to communicate with members by electronicand/orwebsite communications.TheClub'sArticlesallowcommunications to members inelectronicformand,inaddition,theyalsopermittheClubtotakeadvantageofthenewprovisionsrelatingtowebsitecommunications.BeforetheClubcancommunicatewithamemberbymeansofwebsitecommunication,therelevantmembermustagreethattheClubmaysendorsupplydocumentsorinformationtohimby meansofawebsite,andtheClub musteitherhavereceivedapositiveresponseorhavereceivednoresponsewithintheperiodof28daysbeginningwiththedateonwhichtherequestwassent.Bysigningaboveandproviding an email address to the Club, the Club will be able to communicate with you electronically and/or through ourwebsite. TheClubwillnotifyyou(eitherinwriting,orbyotherpermittedmeanswhichwillincludebytheClub'semailednewsletter)whenarelevantdocumentorinformationisplacedonthewebsiteandyoucanalwaysrequestahardcopyversionofthedocumentorinformation. Your form will not be effective unless received and accepted by the Company Secretary.

V5 Revised 20.03.15