APPLICATION FORM - The Virago Star Owners Club

WWW.VSOC.ORG.UK
1 - Scotland. 2 - Eire & Northern Ireland 3 - The Wirral, Cheshire
& North Wales. 4 - Northumberland & Durham. 5 - Yorkshire &
Humberside. 6 - Northwest & Cumbria. 7 - South Wales. 8 - West
Midlands. 9 - East Midlands. 10 - East Anglia. .
12 - Thames Valley. 13 - North London. 14 - South London & Surrey.
15 - Kent & East Sussex. 16 - Solent. 17 - South West. 18 - Devon &
Cornwall. 19 - Essex. 20 - Off Shore
VSOC - 103a Hunsworth Lane, Hunsworth, Cleckheaton BD19 4DP
Name
Address
Telephone
XV Model
Year of Manufacture
Vehicle Registration
Chassis No.
Engine No.
Colour
Membership Fee:
Postcode
Full year 1 April to 31 March
£17.50 plus £9 joining fee = £26.50
Six months 1 October to 31 March (only)
£8.75 plus £9 joining fee = £17.75
...or join on-line @ www.vsoc.org.uk
Please make cheques payable to the
VIRAGO STAR OWNERS CLUB
Send to Malcolm Bland
Hon. Membership Secretary
103a Hunsworth Lane, Hunsworth
Cleckheaton BD19 4DP
Signed
Date
OFFICIAL USE ONLY
Membership Number Centre Number
(125 Virago / 650 DragStar etc.,)
I agree to abide by the rules and constitution of the VSOC