Application for New, or Renewal of existing Membership of the MOA

Please PRINT this form and complete in
BLOCK CAPITALS including the standing order mandate and send to: 
John Johnston, 7 Netherfield Road, Harpenden, Herts AL5 2AF
New applicants - complete all boxes. Renewal, just Surname and Boat Name, plus any changes in your details

Personal details

*Surname

*First Name / s

 

Address and post code

     

 

*Email address

   

*Home phone number

 

Boat details                       

*Boat Name

   

*Where berthed

*Class (e.g. Moody 31 / 44 etc)

Sailing area (e.g. East Coast, Solent )

   

*Mobile Phone (the one you take afloat!)

  

*MMSI Number

None of the above information will be disclosed to commercial companies or mailing lists, it is solely for members and club administrative use.
We publish a useful annual membership register sent only to members. 
Only information fields marked  * are included. If you do not wish to be included in this publication tick here (    )

 

Signed .................................................................   Date .........................

Please fill in your bank details below and sign the form.  Make sure it is all on one page when you print it (you may need to adjust your printer settings). We will then add a reference number and forward this to your bank, then forward confirmation that we have done so to you with your Membership Card. 

UK Bank Account Holders only

Standing order form to your bank :  To the Manager

Bank name  
Bank full address  
Bank postcode  
Sort code               -                 - 
Account name  
Account number  

Please pay to The Moody Owners Association account at Lloyds TSB Bank Plc, The Broadway, Ealing.  Sort Code 30-92-82 Account number 01540558

the following amounts:
1. The one off sum of £20 immediately
2. The sum of £20 per annum on 1st Jan 2011 and thereafter annually until further notice. 

Please quote the reference below with the payments   

 

 

All the above information can be obtained from your cheque book - don't fill in the reference box, we will do it before forwarding to your bank.

Signed …………………………….Print Name…………………..……….Date………………

(In accordance with bank mandate)

 

 

 

Non UK Bank Account Holders or other forms of payment

We cannot accept foreign currency since the bank charges nearly half your membership fee to exchange it,
so please organise a Sterling Bank Draft for £20 payable to

The Moody Owners Association account at Lloyds TSB Bank Plc, The Broadway, Ealing.  

IBAN  GB12LOYD30928201540558 Swift LOYDGB2L

With your name and boat name as reference. 
Or
send £20 as cash to the Membership Secretary - address above

We can also accept card payments via Paypal - contact the Membership Secretary for details.