FIRE SERVICE PRESERVATION GROUP

 

MEMBERSHIP APPLICATION FORM

 

Please list ALL persons to be included in membership as only the named members are covered by the Group’s policy of Public Liability Insurance. Please use CAPITALS.

 

Title

Forenames

Surname

1)

 

 

2)

 

 

3)

 

 

4)

 

 

5)

 

 

6)

 

 

7)

 

 

8)

 

 

        Home Address        

 

 

 

 

Post Code

 

        Are you willing to allow your Home Address to be published in the Members Directory? YES I NO*

        (*Please delete accordingly)

Home Phone

 

Mobile

 

          Are you willing to allow your Home Telephone No to be published in the Member’s Directory? YES I NO* (*Please

         delete accordingly)

      

Email

 

         Email address will not be published.

 

        Type of Membership required. Please circle appropriate entry.

Single £25.00

One Person

Family £27.00

Parents and children of any age, maximum 8 persons

Junior £18.00

Under 18

Pensioner £18.00

Over 65

Joint £27.00

Any two persons

 If you own/operate any Fire Appliance or Fire related Appliance please give details on the reverse of this form.

I/We apply for Membership of the Fire Service Preservation Group and I/We agree to abide by the Constitution of the Group and to any further Directives or Rules issued. I/We shall hold the Officers, Committee and Members, either individually or collectively, free from all responsibility in the event of any accident, loss of life or property, or damage arising from participation in any Group activity.

All Applications are submitted to the next monthly meeting of the Executive Committee for approval.

Data Protection Act. Your attention is drawn to the fact that all members’ records, as detailed on this form, will be kept on a computer and will be available only to authorised Group Officers.

Subscription enclosed: £………….. Cheques/Postal Orders should be made payable to “FIRE SERVICE PRESERVATION GROUP”.

Date

 

Signed

 

RETURN TO: Andrew Scott, Group Treasurer, 50 Old Slade Lane, Iver, Buckinghamshire, SL0 90R.

 

 

 

 

APPLIANCE REGISTER QUESTIONNAIRE

 

Please provide information on any Appliance(s) owned/operated. Please use CAPITALS.

 

MOTOR APPLIANCES

 

A)  Year………………..  Reg. No……………….  Make & Model details………………………………………

     Type: Pump/Pump Escape/Water Tender/ Other……………………………………………………………

     Original Brigade…………………………………………………………………………………………………

      Present Condition: Awaiting – Under Restoration/Operational/…………………………………………..

 

B)  Year………………..  Reg. No……………….  Make & Model details………………………………………

     Type: Pump/Pump Escape/Water Tender/ Other……………………………………………………………

     Original Brigade…………………………………………………………………………………………………

      Present Condition: Awaiting – Under Restoration/Operational/…………………………………………..

 

C)  Year………………..  Reg. No……………….  Make & Model details………………………………………

     Type: Pump/Pump Escape/Water Tender/ Other……………………………………………………………

     Original Brigade…………………………………………………………………………………………………

      Present Condition: Awaiting – Under Restoration/Operational/…………………………………………..

 

MANUALS / STEAMERS / TRAILER PUMPS / ETC.

 

D)  Year………………..  Type ……………….  Make & Model details………………………………………

      Original Brigade…………………………………………………………………………………………………

      Present Condition: Awaiting – Under Restoration/Operational/…………………………………………..

 

E)  Year………………..  Type ……………….  Make & Model details………………………………………

      Original Brigade…………………………………………………………………………………………………

      Present Condition: Awaiting – Under Restoration/Operational/…………………………………………..

 

F)  Year………………..  Type ……………….  Make & Model details………………………………………

      Original Brigade…………………………………………………………………………………………………

      Present Condition: Awaiting – Under Restoration/Operational/…………………………………………..

 

NB. If you have additional appliances, please list the same details on a separate sheet. If you jointly own/operate any of the above, with an existing member of the Group, please give details. 

 

G) COLLECTIONS/MODELS ETC.   If you are a serious collector of any of the following, please put a “Y” (for yes) in the appropriate space.

 

1) Badges

2) Books

3) Helmets

4) Memorabilia

5) Models

6) Photos

 

 

 

 

 

 

 

If you do not wish the above list of Appliances and /or Collections, to be published in the Members Directory please state which below.