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Lightwater Angling Society |
| APPLICATION FORM FOR MEMBERSHIP RENEWAL 2009-10 |
| Please fill in the following details in BLOCK
CAPITALS one for each applicant |
Due to a change in Society
rules you must supply a photocopy of your current valid rod licence
so that we can process your membership |
PLEASE
INCLUDE 1 PASSPORT SIZE PHOTOGRAPH WITH YOUR APPLICATION |
| Christian Name..................................................... | Surname........................................................ |
| 2008 - 2009 Membership No........................... | |
| Address: | ................................................................................................................ |
| ................................................................................................................ | |
| ................................................................................................................ | |
| Post Code: | ................................................................................................................ |
| Telephone Number: | ................................................................................................................ |
| E.Mail | ................................................................................................................ |
Membership Requirement (tick
box as required) | Senior |
£21.00 | (inc Canal Permit) | |||
Junior |
£11.00 | (inc Canal Permit) | ||||
Existing Member | Senior Citizen |
£6.00 | ||||
Basingstoke Canal Permit Senior Citizens
only | £4.00 | |||||
Date of Birth Junior Members only | ................................... | |||||
Due
to a change in Society rules you must supply a photocopy of your current
valid rod licence so that we can process your membership |
| PLEASE INCLUDE 1 PASSPORT SIZE PHOTOGRAPH WITH YOUR APPLICATION |
POSTAL
APPLICATIONS
ONLY |
| Chris Watts 4 New Dawn Close, Southwood, Farnborough, Hants, GU14 0PD 01252 680230 |
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