application form

National Association of Advanced Motorcycle Instructors

Application Form

If you would like to join the Association, and satisfy the Qualifications for Membership,

please complete all relevant details on the application form, ^*print it and send to:

Membership Secretary, NAAMI

376 Alcester Road South, Kings Heath

Birmingham

B14 6EW

Title:		First Name:		Surname:

Company:		Phone:
Address:		Mobile:
		Fax:
Postcode:
Email:	Website:

Mailing Address & Contact Details if different from above:
Address:		Phone:
		Mobile:
Postcode:		Fax:
Email:

Details marked in blue are to be entered onto the NAAMI website and registered lists free with membership.

Would you like to use this facility? Yes No

QUALIFICATIONS FOR MEMBERSHIP

Please select your qualifications for membership

Police Motorcyclist Grade/Class 1	- Date of test
with Proven Instructional Ability	- Copy of certificate enclosed
- Serving Police Grade/Class 1
- Retired within 2 years Police Grade/Class 1
- Retired more than 2 years Grade/Class 1 and working in advanced motorcycling industry
		(please specify)
- Proven Instructional Ability
	(please specify)
RoSPA National Motorcycle Diploma	- Date of test/retest
	- Retest due date
	- Copy of certificate enclosed

Other (please specify)	- Date of test/retest
	- Copy of certificate enclosed


Associate Membership

- Have already chosen training programme
		(please specify)
- Need to choose training programme
		(please specify)

PAYMENT DETAILS

Please indicate method of payment and complete the relevant details below

I enclose a cheque payable to 'NAAMI Ltd'

Please charge my: Mastercard Visa Maestro Delta Other

TOTAL AMOUNT:

Card Number			Expires: Month Year

Name on Card			Issue No: (if applicable) 3 Digit Security Code

Signature			Date

Important: Please check that you have enclosed: Completed Application form, Payment & Copy of Certificate(s)

^* If you require an application form through the post, please pass on your contact details via

email/telephone/fax on 0121 444 0440 and we will send one to you.