Membership Form Membership Application Form * denotes required information ------ PERSONAL INFORMATION ------ Full Name (as appears on official documentation)* Date of Birth* Address* Town* County* Post Code* Contact Number* Email Address* Occupation ------ VEHICLE/DRIVER INFORMATION ------ Vehicle Make: Vehicle Model: Number of Operational Seats (Unobstructed/for on call use): Non Standard Vehicle Modifications How many years experience do you have driving 4x4 vehicles? Based on the above, how many years include 4x4 off-road driving? Do you have any motoring convictions in the last 5 years?* YesNo Have you been involved in any motoring accidents (regardless of fault) in the last 5 years?* YesNo Do you have any recognised training? St John's Ambulance - First Aid TrainingLANTRA Recognised 4x4 TrainingBORDA Recognised 4x4 TrainingROSPA 4x4 TrainingOther Off Road Driver TrainingTrailer TowingOff Road Recovery (including Winching)Water RescueHighways QualificationsOther If other, please list: ------ REGISTRATION INFORMATION ------ Which role are you interested in?* SupportResponderOther Lastly we would appreciate if you could describe a little bit about yourself and how you found out about Hertfordshire 4x4 Response: By submitting this form you acknowledge that your application will be reviewed and that you may be subject to a Disclosure and Barring Service check upon successful application. You also agree to make known, any reason why you may fail such checks.