2011 HSA Membership Application Form

Please print out this page, complete the form and send to: David Smith, Hillclimb & Sprint Association, 11 Wellington Drive, Bowerhill, Melksham, Wilts SN12 6QW together with a cheque made payable to "The Hillclimb & Sprint Association".

Please Tick Box
Single Membership Fee (Including SPEEDSCENE Magazine) £46
 
Joint Membership Fee (Family member at same address, including one magazine) £60
 
Plus joining fee per member £  2
 
HSA Cloth Badge £  5
 
HSA Inside Sticker £  3
 
HSA Outside Sticker £  3
 
Subscription to SPEEDSCENE Magazine UK £ 36
 
Subscription to SPEEDSCENE Magazine Europe Air Mail £ 45
 
Subscription to SPEEDSCENE Magazine Rest of World Air Mail £ 51
 
Name
Name (Joint member)
Address
 
 
Phone Email
Signed Date