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Membership Form

First Name .............................
Surname
...............................


Address...............................
.....................................
.....................................
.....................................
.....................................

Phone Number .........................

E mail Address .........................

Please tell us about your Scamp
(don't be put off joining if you don't own a Scamp)

Type Mk1............Mk2............MK3............Suzuki...........

Reg No ............................Chassis No.........................

4 wheeler ........................6 wheeler...........................

Other Information......................
......................................
......................................


Please send the completed form plus a cheque for £16 made out to 'Scamp Owners Club'

Jeannette Spindler,
17 Mevagissey Road,
Brookvale,
Runcorn,
Cheshire,
WA76BD