To join us at the Potteries Model Boat Club, complete the application form below and click the submit button.  If a mistake is made then click the reset button to start again. The form will be sent electronically to the Club Secretary who will contact you in due course. Once your application has been accepted,  you will be informed of the subscription rate that will be due from that time. A Membership pack will be forwarded once subscriptions have been paid.

ADDRESS

TELEPHONE NO..

E-mail

Age Group

I, (Name)

Address

Town/City

Postcode

Home Telephone

I Agree / Disagree to my address and/or telephone no. being published in the club directory.

Select as appropriate and then select your age group. (Please note no under 18’s allowed).

Occupation (if any)

Agree

Disagree

Agree

Disagree

Under 18

18 -64

65 or Over

Scale Models

Scale Yachts

Racing Electric Boats

Building Static Models

Other

My Interests are :- (Interests / models)