Rochdale Owners Club Membership Form

Please fill in as many details as possible

Print out the form and then post it to the club secretary

Name:
 E-mail:
Address:

Telephone
(Home):


(Work):


Postcode:
Rochdale Model:
 Reg. No. (Plus original if altered):
Date First Registered
(From log book):
 Date Bought:
Colour (Now):
 (Originally):
Chassis Used (early cars):
 CHASSIS No.:
ENGINE (type & capacity):
 ENGINE No.:
TRANSMISSION (make/No. of gears):
 REAR AXLE (make/ratio):
FRONT SUSPENSION:
 REAR SUSPENSION:
WHEELS (make/size):
 TYRE SIZE:

Condition of car:

 TRIM COLOUR:
Details of condition:
DASHBOARD/INSTRUMENTS

Are you willing to make the car available for shows?
Do you have any record of the car's construction and subsequent history?  Are you aware of any modifications, including those you have made yourself?
The Registrars will always be pleased to hear of any Rochdales you have owned or known in the past. Please give as much detail as you can remember!

 

Please return this form to the Secretary:

James Farrington

33 Gibson Road

Ickenham

Uxbridge

Middlesex

UB10 8EW

UNITED KINGDOM


Copyright © 2009 Rochdale Owners Club