Before submitting the membership form, please ensure that you have read the Membership & Tuition Information page.

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Name *

First

Last

Address, including post code *

Email *

Phone *

Occupation *

Date of birth *

Make & model of car/motorcycle

Annual mileage

Number of years experience

Driving or riding qualifications

confirm code Gift

Type of application (please choose one) *

• Advanced driving tuition (£20)
• Advanced riding tuition (£35 - first year only, see below)
• Group member without tuition (£20)

Please confirm *

• I have read the Membership & Tuition Information page

Gift Aid (see below)

• Please confirm that we can treat all gifts of money that you make as Gift Aid donations

Training

• Please confirm that you consent to your information being shared within the group for training purposes

Communications

• Tick this box to be provided with information about Group activities and events by email or post

Submit

After submitting the form, please either set up a bank transfer for payment of the appropriate amount to:

• Account name: West Yorks RoSPA Advance Drivers Assoc
• Sort Code: 05-00-90
• Account number: 54352992.

Please put your name in the reference field.

Alternatively, send a cheque payable to “West Yorks RoSPA Advance Drivers Assoc” to:

RoADAR Membership,
3 Craig-y-Don,
Earlsheaton,
Dewsbury,
WF12 8BJ

Please note that your name should be written in capital letters on the back of the cheque.