2016 HSA Membership Application Form

Please print out this page, complete the form and send to: David Smith, The 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) £50
 
Joint Membership Fee (1 additional member at same address, including one magazine) £64
 
Joint Membership Fee (2 additional members at same address, including one magazine) £78
 
HSA Cloth Badge £  5
 
HSA Inside Sticker £  3
 
HSA Outside Sticker £  3
 
Subscription to SPEEDSCENE Magazine UK £ 40
 
Subscription to SPEEDSCENE Magazine Europe Air Mail £ 49
 
Subscription to SPEEDSCENE Magazine Rest of World Air Mail £ 55
 
Name
Name (Joint member)
Address
 
 
Phone Email
Signed Date
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