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BARNTON & FRODSHAM ANGLING CLUB

MEMBERSHIP APPLICATION 2012/2013

If you wish to apply for membership of the Club, please complete this form and return it together with a cheque or postal order - made payable to ‘Barnton & Frodsham AC’ - for the appropriate amount and a stamped addressed envelope (minimum size of 23cm x 16cm) to:

Barnton & Frodsham AC

P.O. Box 297

Northwich

Cheshire,

CW8 4XX

Multiple Applications - if you submit more than one Application for Senior and/or Junior Memberships ensure you send a larger stamped address envelope (minimum size of 25cm x 18cm) with Large Letter Stamp.

The fee rates for a new member for 2012/13 are:Seniors - £20 + £12 joining fee + £3 for a copy of the Club key (if required) = £35

OAPs (65 years or older) - £10+ £12 joining fee + £3 for a copy of the Club key (if required) = £25

Juniors (8 to 15 years, inclusive) = £4

Membership Requirements:

Type of membership for 2012/13:   Senior / OAP (delete as needed)

Club key – (this opens the gates at Heesom’s Pool, Longton’s Pool and the Rifle Range car park) - required: Yes/No

Name: ………………………………………………………………………………………..

Address: ……………………………………………………………………………………..

………………………………………………………………………………………………..

Date of Birth: …………………………      Value of your cheque/postal order: £ ………….

Telephone no:     ……………………………………………………….

E-mail address (optional):   ……………………………………………………….

If you require any Junior cards, please give the name and date of birth of the child/children:

Name: ………………………………………………. …          DOB: ………………………

Name: ………………………………………………. …          DOB: ………………………