| Please return the completed form to: |
|
Mrs Pauline Neal
Membership Secretary 2 Russell Court Cleethopes DN35 0NT |
I/We wish to apply for membership to the LWRS
(Please make cheques payable to LWRS)
| Please tick boxes as required: | ||||||||
| Full | £13.00 |
|
Joint Full | £20.00 |
|
|||
| Senior** | £8.00 |
|
Joint Senior | £12.00 |
|
|||
| Junior | £6.00 |
|
Family* | £26.00 |
|
|||
**Over 60 *2 adults/2 children under 16
Life Membership |
||||||||
| Single | £180.00 |
|
Joint | £240.00 |
|
|||
| Name (1) | ||||
| Mr / Mrs / Miss / Ms | ||||
| Name (2) | ||||
| Mr / Mrs / Miss / Ms | ||||
| Address | ||||
|
Post Code
|
||||
| Telephone Number | ||||
| Email Address | ||||
|
Date of Application
|
||||
|
Family Applications - please name all children under 16
|
||||
|
For keeping track of the membership records your details are |
|