Join the SSVC

Join the Split Screen Van Club

The club membership fees as of January 1st 2009 are:
Initial joining fee £6
UK resident annual fee £25
Non UK resident fee £30

Please allow 14 days for memberships to be processed

Name

Email Address

Telephone Number (Inc STD)

Van Registration Number

House Number/House Name

Name of Road or Street

Suburb (optional)

Town

County

Post/Zip Code

Country

Are you able to assist the club in any way e.g. (Shift Click to Select Multiple)

Are you able to help members with any of the following:(Shift Click to Select Multiple)

Where did you hear about the club?

Membership requires details to be kept on computer. If you do not wish your membership details to be known to other members please tick.

Card Type

Issue Number

VISA/MASTERCARD/SWITCH Number

Name on the Card

Expiry Date:

Start Date (if shown):

Security Number (on rear of card, if shown)

If you own a Split Screen Van - please Register it with the Club. To do this, please select "Van Register" once you have completed this form