|
|
|
|
SURREY WALKING CLUB
|
|
Founded 1899 Affiliated to UKA SEAA & RWA
website:
www.surreywalkingclub.org.uk
|
| Tel: 01403 270877
email: hannellpc@aol.com |
Hon.
Secretary: Peter Hannell
70 Irwin Drive
Horsham
West Sussex RH12 1NJ |
|
|
Membership Application form
|
|
To
the Hon. General Secretary
|
Dated...........................................................20..... |
| |
| I wish to
become a member of Surrey Walking Club and ask you to place this
application before the Committee at their next meeting.
I
enclose a cheque for £......................
being my first subscription which is due on election. If elected, I agree to
abide by the Rules of the Club, including the payment to the Club of future
subscriptions and any other payments as they become due from me. I agree to give
the written notice, as determined by UKA and Club Rules, of my resignation from
the Club should I wish to do so.
Subscription rates: Seniors £5.00;
Full-time students and Under 18s: £2.00
I
declare that I am an "Amateur" as defined by the laws of the governing
body of Athletics.
I declare that I have never competed at any sports not registered by the UK
Athletics Federation or had my entry for any event refused.
I
have never had my application for any Club or Society refused or my membership
to such an organisation cancelled.
|
|
Applicant's
signature...................................................... |
Parent's signature (if under 18)...................................... |
| |
Date......................................................................... |
|
Proposed
by.................................................................. |
Member's Name (print)................................................. |
| |
|
|
Seconded
by................................................................. |
Member's Name (print) ................................................ |
| |
| Date on
Election............................................................ |
Chairman's Signature................................................... |
| |
|
|
Applicant's
details - Please Print
These details will not be
revealed outside the membership or used for any commercial purpose (Data
Protection Act) |
|
Forename.................................................................... |
Surname................................................................. |
| |
|
| Phone
(home/mobile)..................................................... |
Phone
(work).......................................................... |
| |
| Email
address.............................................................. |
| |
|
Address....................................................................................................................................................................
...............................................................................................................................................................................
Post
Code...................... |
| |
|
Nationality
......................................................................... |
Date of
arrival in UK if born overseas...................................... |
| Other Athletics Clubs of
which you have been a member.................................................................... |
| Date of resignation or are
you still a member?
................................................................................. |
| Principal meetings, if
any, at which you have competed:
................................................................... |
| |
|
Note: All applicants are expected to have attended a Club event prior to
election. |
