Your details

	I/We would like to apply for membership of the London & Thames Valley VW Club and agree to abide by the rules of the Club.
	Forenames		Surname
	Address 1
	Address 2
	Town/city		County
	Postcode		Telephone
	Email
	If joint membership required, please give details:
	Are you already registered on the LTV Forum? If so give us your forum name :

Your VW (if you have one)

	Model (please select one)
	T1 Beetle	T1 Beetle 1302	T1 Beetle 1303	T2 Van/Bus/Camper
	T25 Van/Bus/Camper	T4 Van/Bus/Camper	T5 Van/Bus/Camper	Type 3/4
	T1 Karmann Ghia	T3 Karmann Ghia	New Beetle	Corrado
	Golf	Golf GTi	Jetta	Lupo
	Passat	Polo	Scirocco	Sharan
	Vento	Other
	Type (please select one)
	Saloon	Cabriolet	Bay window	Split window
	Crew Cab	Squareback	Notchback	Fastback
	Estate	Beach Buggy/Baja/Kit	N/A
	Other
	Year of manufacture		Engine size in cc
	Registration number		Colour(s)
	Name
	Any comments/modifications If you have more than one VW, please include details in the comments picture and details of your VW, if you would like it included in the Club magazine.

How did you hear about the LTVVWC?

	Friend/Family	Advert	Club Postcard	VW show
	Internet search	I have been a member before

Your VW the star

	The Club is regularly contacted by film companies, advertising agencies, TV, radio and the press, who wish to feature members and their VWs. If you would like to be considered (regardless of your VW’s condition) please indicate.
	Yes	No

Payment

	Now you can choose your payment method:
	Paypal / Credit Card	Cheque

	PayPal PayPal details are on the next page, so please submit this form first.	Cheque Ensure your cheque for £15 is made payable to "London & Thames Valley VW Club" and has your name and address written on the reverse. Post to: Membership Secretary, LTV VW Club, PO Box 3414, Wokingham, RG40 1ZW.

Data Protection Act 1998

Personal data supplied on this form will be held on the LTVVWC database which is registered with the Data Protection Register. As part of our discount and benefit arrangements, we regularly submit just member’s names and membership numbers to participating companies. The Club will never disclose any other information to third parties.