EMLRA Postal Payment Application Form
  1. Main Applicant
  2. First Name:(*)
    Please type your first name.
  3. Last Name:(*)
    Please type your last name.
  4. Associate Applicant (must be resident at same address)
  5. First Name:
    Please type your first name.
  6. Last Name:
    Please type your last name.
  7. Address Details
  8. Address Line 1: (*)
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  9. Address Line 2: 
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  10. Town:(*)
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  11. County/State:
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  12. Post Code/ZIP:(*)
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  13. Country:(*)
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  14. Telephone:
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  15. Mobile Number:
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  16. E-mail(*)
    Invalid email address.
  17. You can choose to receive the Newsletter electronically (via an emailed link) or as a hard-copy
  18. Newsletter type
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  19. Vehicle Details
    The EMLRA archive provides an invaluable source of information on members vehicles and has been actively maintained
    for more than twenty years. We would therefore appreciate you taking a little time to fill this in as accurately as you can.
    If you have no details then enter "no details".
    If you have more than one vehicle you will be able to provide details of others after you have joined via the members only
    area of the website.
  20. Vehicle type:
    (eg 4x4, FFR, RHD. Please state clearly whether a L/weight, 90, 110 etc).
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  21. Only membership number (if known), name, first line of address and email address required. Please provide other details if they have changed
  22. AVC Code:
    (eg 1720 0778)
    Invalid Input
  23. MOD Registration:
    (eg 16 GX 60)
    Invalid Input
  24. Contract Number:
    (eg LV2A/004)
    Invalid Input
  25. Date of Manufacture/Date
    into Service:
    Invalid Input
  26. Date Released from service:
    Invalid Input
  27. Chassis Number:
    Invalid Input
  28. Engine Type:
    Invalid Input
  29. Known History or
    information of interest:
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  30. Publication consent
    We may publish your town, county and country of residence in the club newsletter along with information about the type of vehicle/s you own. Do you consent to this?
  31. Publication consent
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  32. Invalid Input


  33. Confirm you are human by entering the word (all lowercase letters) into the box below
  34. In EMLRA what does the 'm' stand for?(*)
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  35.