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We are planning to have on-line membership available - via a secure server - in the very near future.  In the meantime can we ask you to please complete the information below, which will enable us to send you a membership pack by snail-mail very shortly.

Please note that the items asterisked (*) are mandatory, so we can supply the information to you efficiently.  You will have the opportunity to view a confirmation page, so If you enter the information incorrectly, you can use the 'back' button of your browser to correct this.

Please provide the following contact information:
*First Name  
*Last Name  
*Title  
*Street Address 1  
Street Address 2  
*City  
*County/State/Province  
*Zip/Postal Code  
Country  
Work Phone  
*Home Phone  
FAX  
*E-mail address  
*Do you have a Stag?  
Other club(s) you belong to  
*Publication you found us from  
Please note that this information will not be divulged to any third party in any format without your express written permission.

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Copyright � 2006, 2011, 2013 Triumph Stag Register                                                    Last modified: July 30, 2013