I would like to join the AC Locomotive Group

First Name                                           Surname

Address





Postcode

Email address

Tick: Adult                      Child                     

£      :    

Tick: Electronic                      Postal                     

Donation (optional)

£      :    

I enclose a cheque made payable to "The AC Locomotive Group" for the sum of:

£      :    
TOTAL

Signed

Age (if under 16)

Membership Rates: Adult £16, Junior (under 16) £8.

Please return with payment in Pounds Sterling to:

ACLG Memberships
67 Somersby Avenue
Walton
CHESTERFIELD
Derbyshire
S42 7LY
United Kingdom