OHJAC Membership Application 2010/11

 

1st February 2010 - 31st January 2011

Member Details

I agree to abide by the club rules and code of conduct and I am aware that my details will be kept in a computerised database by the Membership Secretary.

 

Signature …………………………………..

 

Date ……………………

 

 

Please post this form to the Treasurer, Peter Fletcher, 25 East Budleigh Road, Budleigh Salterton, EX9 6EJ to arrive no later than Thursday, 18th February 2010.

Surname

 

Forenames

 

Address

 

 

 

 

 

Postcode

 

Telephone Number

 

Email address

(Please Print Clearly)

 

 

 

I enclose £20.00 renewal fee

 

 

or

 

 

I enclose £20.00 joining/

 

 

membership fee

 

 

 

 

 

I am aged over 18