AHC

100 REGISTER - Registration Form

DETAILS OF YOUR 100

Type: e.g. BN1LM Chassis Number

Batch Number Body Number Engine Number

Build Date (dd/mm/yy) Date First Registered

Original Body Colour Body Colour Now

Original Trim Colour Trim Colour Now

Condition

A=Concours B=Good C=Fair D=Poor, but in use E=Off the road or under restoration

If Left Hand Drive please enter LHD

YOUR DETAILS

Title (Mr. Mrs. Dr. etc.) Initials

First Name Surname

Wife or Partner's first name

Address

Postcode or Zip Code Country

Telephone Numbers

Home Work Fax

Your

Email address

Email

YOUR CLUB

Name Membership Number

If all the above details are correct please press the Send button.

If you have further information which you think is of interest then please send me an Email at

100reg@jharper.demon.co.uk