London Vintage Taxi Association
American Section
Membership Application
(You can complete most of this form prior to printing, signing and posting if you wish)
Please complete, and return this form with your remittance payable to L.V.T.A. to:
John DeRoy, U.S. L.V.T.A. Membership Secretary, 17 Via Magnolia, Newbury Park, CA 91320
Name:

Address:

Home telephone:

Work telephone::

Fax:

Email address
1. Do you own a taxicab? If so, please give the original GB registration and model/description:

2. Do you have any other historic vehicles?

3. Do you have any skills or facilities that you think would assist other members?

4. Do you use your taxi(s) in any commercial enterprise?

I wish to apply for membership in the London Vintage Taxi Association.
USA/Canada annual dues £38.00 . Applicants may pay £20.00 after July 1st. Additionally there is a one-time joining fee of £5.00, which should be added to your payment.
Signed: ………………………………………………… Dated: ………………….. Date payment transmitted to UK
Treasurer: ………………………………………………
Please return this completed form to John DeRoy, US LVTA Membership Secretary, 17 Via Magnolia, Newbury Park, CA  91320  or send via email attachment to lvta.usca@gmail.com
Contact John Freeston (jcfreeston@comcast.net)  or John DeRoy (lvta.usca@gmail.com) for payment instructions. Payments should not be sent to the Membership Secretary