Membership Application

The: Cotswold Oil Engine and Preservation Society

Application for membership

Name:____________________

Address:__________________

_________________________

_________________________

Post Code:________________

Tel No:___________________

Enclose cheque for: £10 Membership Full Insured Public Liability. £5,000,000 Cover.

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£5 Associate/Junior (under 16) NOT INSURED.

All cheques Payable to: C.O.E and P.S.