Holden UK Register
MEMBERSHIP FORM
Name
Address
Tel .......................................
CAR DETAILS
Model.
YearEngine Size. Body Type
Registration Number
Body Number Chassis Number Engine Number
………………. .…………………. …………………..
Special Features - Condition - Other Details:-
I enclose £ ……………. or equivalent in $Aus
Please return this form to - Membership Secretary:
Guy Hardy 5A Gorsey Bank Wirksworth
Derbyshire DE4 4AD
Tel:01629 820814