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Membership 		TR3OC Membership Application Form
Please print out the form and fill in using block capitals.

Send it with the appropriate membership fee to:
Sam Milner - Membership Secretary
51 Northwood Road, Prenton, Birkenhead, Merseyside, CH43 0SR, UK


Member Details
Surname _______________________________________________
First Names _______________________________________________
   
Address _______________________________________________
  _______________________________________________
Town or City _______________________________________________
County / State _______________________________________________
Post / Zip Code _______________________________________________
Country _______________________________________________
Phone No. Please include area code. ___________________________
E.mail Address _______________________________________________

Associate Member
Surname _______________________________________________
First Names _______________________________________________

Yearly membership fees in £ Sterling
   UK
 Rest of World 		£25.00
£29.00 		   Europe
 Associate Member 		£27.00 
£2.00  		 

Payment Details
I enclose a cheque/postal order (£ sterling or Eurocheques only)
  made payable to: "Trident & Rocket Three Owners Club"for the amount of £_______  
Or ..............
I wish to pay by credit card (please tick).
  Mastercard____    VISA____    Eurocard____     Delta____
Card No. _______________________________________________
Expiry Date _______________________________________________
   
Cardholder Name (as shown on card)
_______________________________________________
Cardholder Address (if different to above)
_______________________________________________
  _______________________________________________
Town or City _______________________________________________
County / State _______________________________________________
Post / Zip Code _______________________________________________
Country _______________________________________________

Please give details of your bike
Make __________________   Model __________________
Frame No. __________________   Engine No. __________________
Colour __________________   Owned since __________________
Reg. Number __________________   Reg. Date __________________
 
History (where applicable)
Date 1st Reg. __________________   Country 1st Reg __________________
Original colour __________________   No. of owners __________________
 
Main use Work______   General______   Pleasure______   Racing_______
Modifications ___________________________________________________
  ___________________________________________________
  ___________________________________________________

Additional bike details
For lucky people with more than one Triple, please fill out the bike details on a separate sheet and send with this form.