Neil Howard Stages in association with G Coffey Solicitors 2018 - Internet Entry Form

Entries to this event are now closed and this page is for record only

Neil Howard Stages

In Association With

Graham Coffey Solicitors 2018

WWW.NHSTAGES.CO.UK

#NHStages

Welcome to the Neil Howard Stages in association with Graham Coffey Solicitors 2018

With a number of further event improvements from last year as well as continuing to be the opening round of the Motorsport News Circuit Rally Championship in association with MSVR, we at Bolton-le-Moors Car Club are sure you will really enjoy this years rally.

Entries Open 14th September 2018 @ 20:00 at the rate of £305.00

Entries Close for seeding on 26th October 2018 @ 20:00

Entry Tickets emailed to fully paid entries - W/C 28th October 2018

Note: Enties open at the same time for all competitors however, only Motorsport News Circuit Rally Championship competitors will be accepted in the first 24 hours. Once this period has expired we will accept further entries on a first completed entry first served basis

Entries Secretary: Jack Mather

11 Lupin Close

Whittle-le-Woods

Chorley

Lancashire

PR6 7RG

Telephone 07568 555242 (Between 19:00 and 23:00)

e-mail: entries@nhstages.co.uk

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FISA) and the Supplementary Regulations

Welcome to the "Neil Howard Stages in association with Graham Coffey Solicitors 2018" Online Entry system. Please follow the steps below to enter the rally.

Complete all the fields in the form below. The fields with red backgrounds are mandatory.
Once you have hit the "Enter the Rally" button at the end you will receive an automated response confirming we have received your entry form.

There are several ways to pay your entry

PayPal - boltonlemoors@gmail.com
Cheque (To the entry secretaries address payable to Bolton-Le-Moors Car Club Ltd)
Cash (Delivery in person to the entry secretary)

If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-

Bank	Santander
Sort Code	09-01-50
Account No.	04373782
Account Name	BOLTON LE MOORS CAR CLUB LTD
Reference	Drivers Full Name (Failure to provide this will delay your application)

Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. Note: Without payment your entry will not be valid (this includes reserves places).
If you don't receive a response within 5 days of the expected payment date, or if you have any other questions, please e-mail Jack entries@nhstages.co.uk

All the fields with a red background must be filled in, or you will not be able to continue. Please put TBA in any red field which you do not know the details for and, as soon as these details are known, please email them to the entries ecretary.

Document Addressing

E-Mail address for communication This must be filled in to continue

Real Name of this person This must be filled in to continue

Whom should we send final instructions and entry tickets to? This must be filled in to continue

Driver

Co-Driver

Driver

Full Name This must be filled in to continue

Address This must be filled in to continue

Post Code This must be filled in to continue

Home Town This must be filled in to continue

Telephone Number

Mobile Number

Competition Licence Number This must be filled in to continue

Competition Licence Issuer

E-Mail Address This must be filled in to continue

Club (If no club is entered in here it is assumed you will require membership of BLMCC) You cannot sign on until this is filled in

Club Membership No You cannot sign on until this is filled in

Nationality

Helmet Make You cannot sign on until this is filled in

Helmet Model You cannot sign on until this is filled in

Helmet Approval Standard You cannot sign on until this is filled in

FHR Make You cannot sign on until this is filled in

FHR Model You cannot sign on until this is filled in

FHR Approval Standard You cannot sign on until this is filled in

Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Number

Competition Licence Issuer

Co-Driver

Full Name This must be filled in to continue

Address This must be filled in to continue

Post Code This must be filled in to continue

Home Town This must be filled in to continue

Telephone Number

Mobile Number

Competition Licence Number This must be filled in to continue

Competition Licence Issuer

E-Mail Address

Club (If no club is entered in here it is assumed you will require membership of BLMCC) You cannot sign on until this is filled in

Club Membership No You cannot sign on until this is filled in

Nationality

Helmet Make You cannot sign on until this is filled in

Helmet Model You cannot sign on until this is filled in

Helmet Approval Standard You cannot sign on until this is filled in

FHR Make You cannot sign on until this is filled in

FHR Model You cannot sign on until this is filled in

FHR Approval Standard You cannot sign on until this is filled in

Co-Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Issuer

Car Seats and Harnesses

Left Harness FIA Homologation Expiry Date You cannot sign on until this is filled in

Right Harness FIA Homologation Expiry Date You cannot sign on until this is filled in

Left Seat FIA Homologation Expiry Date You cannot sign on until this is filled in

Right Seat FIA Homologation Expiry Date You cannot sign on until this is filled in

Car Fire Extinguishers

Hand-held fire extinguisher make You cannot sign on until this is filled in

Hand-held fire extinguisher capacity You cannot sign on until this is filled in

Hand-held fire extinguisher last service date You cannot sign on until this is filled in

Plumbed-in fire extinguisher make You cannot sign on until this is filled in

Plumbed-in fire extinguisher capacity You cannot sign on until this is filled in

Plumbed-in fire extinguisher last service date You cannot sign on until this is filled in

Sponsor

Sponsor Name (Note: this sponsor does not need an entrant's licence)

Did you know your sponsor could advertise in the official event programme from as little as £100. Please contact Blmcc Media and Communications officer for details. media@nhstages.co.uk You cannot sign on until this is filled in