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CLITHEROE & DISTRICT MOTOR CLUB Membership Application Form 2017 |
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NAME
Partners Name (Joint) ADDRESS |
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CONTACT DETAILS ( you agree to club updates either by text or
email) Telephone
Mobile Email (print) |
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Please Fill in Below For Junior Membership Application Name of Parent/Guardian Address (if different from above) Signature of
Nominee__________________________________ Date_______/_______/20___ In the case of a junior member as parent/guardian * I give
permission for the above to apply membership of Clitheroe & District
Motor Club . Signature *Parent/Guardian
______________________________ Date ______/______/20___ |
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*I/We wish to be
nominated for *single/joint/junior membership of Clitheroe and District Motor
Club and in the event of election hereby undertake to observe the rules and regulations
of the club for time being in force. (*delete as appropriate) All members
accepted subject to committees discretion, at the next committee meeting. All membership/nomination papers should be accompanied by the
appropriate fee. Membership Fees for 2017. Full @ £10.00
Joint @ £12.50
Junior @ £5.00 |
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NOMINATION FOR MEMBERSHIP (not for renewals) We the undersigned, being
members of Clitheroe and District Motor Club, propose and second the above
named for election to Membership of CLITHEROE AND DISTRICT MOTOR CLUB. (Both proposer and seconder MUST be fully paid up members of
Clitheroe and District Motor Club and must have been for not less than the
previous 3 months) Proposer
_____________________________________________
Seconder _____________________________________________ Date ______/______/20____
Date______/_______/20_____ Signed
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Signed ________________________________________ |
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Please return completed form to: Terry Martin 16 Newington Avenue Blackburn Lancs BB1 9RG Email terrymartin01@aol.co.uk |
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FOR OFFICIAL USE ONLY Date Received
______/________/20___
Subscription Received £_____________ cash /
chq Voted on by
Committee
_______/_______/20____ Event
Joined at ________________________________________________________
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Membership No. ____________________
Clubcard
Issued 0n ______/______/20_____
post / by hand |