Gail's Ford Cortina Page - www.Cortina80.co.uk

Ford Cortina Owners Club - Membership Application Form

Membership costs £15.00 per year (April to April)

Gail's Ford Cortina Page - www.Cortina80.co.uk

Name :
Address:
Post Code:		Tel no:
Mobile:
E-Mail:
Forum Name:
Chassis No:
Transmission:
Engine size:	cc	Colour:
Registration:		Year of manf:
My Cortina is:
Saloon		Estate
MK1		MK4
MK2		MK5
MK3
Taunus		P100
Version	GXL, L, Ghia etc
Would you like to have your car considered for possible photo / film shoots in the future?		Yes:	No:
Any history or Mods: (Please continue overleaf)

Please make your cheque payable to:

The Ford Cortina Owner’s Club

And send it, along with this form to:

Anne Dickinson
Membership Department
5 Cromer Road
Bispham
Blackpool
LancashireFY2 0ED

Tel:- ( 01253 ) 356068 e-mail: j_a.dicki-5@tiscali.co.uk