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.
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Forenames |
Surname |
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3) |
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4)
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5)
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6)
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7)
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8)
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Home Address
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Post Code |
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Are you willing to allow your Home Address to be published in the
Members Directory? YES I NO*
(*Please
delete accordingly)
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Home
Phone |
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Are you willing to allow your Home Telephone
No to be published in the Member’s Directory? YES I NO* (*Please
delete
accordingly)
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Email |
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Email
address will not be published.
Type of Membership required. Please
circle appropriate entry.
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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”.
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Date |
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Signed |
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RETURN TO: Andrew Scott, Group
Treasurer,
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.
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1)
Badges |
2)
Books |
3)
Helmets |
4)
Memorabilia |
5)
Models |
6)
Photos |
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If
you do not wish the above list of Appliances and /or Collections, to be
published in the Members Directory please state which below.