EMLRA PayPal Renewal Form
  1. Only membership number (if known), name, first line of address and email address required. Please provide other details if they have changed
  2. Membership Number:
    Invalid Input
  3. Main Applicant
  4. First Name:*
    Please type your first name.
  5. Last Name:*
    Please type your last name.
  6. Associate Applicant (must be resident at same address)
  7. First Name:
    Please type your first name.
  8. Last Name:
    Please type your last name.
  9. Address Details
  10. Address Line 1: *
    Invalid Input
  11. Address Line 2: 
    Invalid Input
  12. Town:
    Invalid Input
  13. County/State:
    Invalid Input
  14. Post Code/ZIP:
    Invalid Input
  15. Country:
    Invalid Input
  16. Telephone:
    Invalid Input
  17. Mobile Number:
    Invalid Input
  18. E-mail*
    Invalid email address.
  19. You can choose to receive the Newsletter electronically (via an emailed link) or as a hard-copy
  20. Newsletter Type:
    Invalid Input
  21. (you will be sent a link to a downloadable version
    of the newsletter as soon as it is sent to print)


  22. Vehicle Details
    (we would appreciate you taking a little time to fill this in as
    accurately as you can. If you have no details then enter "no details")
  23. Vehicle type:
    (eg 4x4, FFR, RHD. Please state clearly whether a L/weight, 90, 110 etc).
    Invalid Input
  24. AVC Code:
    (eg 1720 0778)
    Invalid Input
  25. MOD Registration:
    (eg 16 GX 60)
    Invalid Input
  26. Contract Number:
    (eg LV2A/004)
    Invalid Input
  27. Date of Manufacture/Date
    into Service:
    Invalid Input
  28. Date Released from service:
    Invalid Input
  29. Chassis Number:
    Invalid Input
  30. Engine Type:
    Invalid Input
  31. Known History or
    information of interest:
    Invalid Input
  32. Cost:
    0.00 GBP


  33. Publication consent
    We may publish your town, county and country of residence in the club newsletter along with information about the type of vehicle/s you own. Do you consent to this?
  34. Publication consent*
    Invalid Input
  35. Data protection
    Invalid Input


  36. Confirm your human by answering the question below. Enter answer in lowercase.
  37. In EMLRA what does the M stand for?*
    Invalid Input
  38.