The Balcombe Club                          Fees Paid:    Senior ___
Victory Hall, Stockcroft Road,             
BALCOMBE, West Sussex. RH17 6HP                  Ordinary ___
              
Telephone 01444-811226                                     Junior ___
Email: info@balcombeclub.co.uk
	
APPLICATION FOR MEMBERSHIP

FULL NAMES OF APPLICANT(S) In Block Capitals please        Date    ____________

SURNAME   				FIRST NAMES

1.                         		                                   (Mr/Mrs/Ms/Miss)

2.                         		                                   (Mr/Mrs/Ms/Miss)

FULL POSTAL ADDRESS    ……….	________________________________________

DATES OF BIRTH			________________________________________                                

1. ___________ 2. ____________      POSTCODE _________

PHONE No’s 1				|      PHONE No’s 2
| 
Home:  ______________________	|      _________________________
					|
Mobile: ______________________	|      _________________________

E-Mail Address 1   ____________________________________

E-Mail Address 2   ____________________________________

PROPOSERS (Full Names)

PROPOSER _______________ SIGNATURE_____________(Membership No        )

SECONDER _______________ SIGNATURE_____________(Membership No        )

You are requested to read the following carefully.

Please hand this form, after completion, to a member of staff together with the relevant membership fee (see below).
Please note:-
(i)  That the Committee formally approve new members and in the unlikely event of membership not being ratified, for whatever reason, all monies paid will be returned.
(ii) Full membership is only granted, when approved by the Committee and not when this form is completed and monies paid.
(iii) Information provided is stored in the Club Membership Database for administration purposes only.
Current Membership Fees - £30-00 - (£15-00 Half yearly July to December)
Senior Citizens (OVER State Pension Age) £15-00 (£10.00 half-year – July to December).
15-17 years old inclusive £15-00 (£10-00 half-year - July to December)
Please remember that Membership fees are due for annual renewal in January.