EMLRA Postal Payment 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:
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  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: (*)
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  11. Address Line 2: 
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  12. Town:
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  13. County/State:
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  14. Post Code/ZIP:
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  15. Country:
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  16. Telephone:
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  17. Mobile Number:
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  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
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  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).
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  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:
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  29. Chassis Number:
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  30. Engine Type:
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  31. Known History or
    information of interest:
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  32. 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?
  33. Publication consent
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  34. Invalid Input


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