Application Form 2010 Membership No........................
Raynor-Angling Club
Application for Membership
Full Name …………………………………………………….
Address ………………………………………………………
……………………………………………………….
……………………………………………………….
Post Code ……………………
Email Address ……………………………........Tel No...........................................
Current vehicle Make ……………….Colour ……………… Registration No. …………
Date of Birth ……………I am applying for Full / Senior citizen / Junior/ Membership.
I enclose cheque/P.O. for £……. As my membership fee made payable to; Raynor A.C.
Full membership 16+ Fee £30.00
Senior Citizen membership 65+ Fee £25.00
Junior membership up to 16 years Fee £20.00
Membership runs from Jan 1st to Dec 31st
Subject to my application being approved, I agree to abide by the club rules and all the instructions and notices in force by Garlands shooting grounds and Camp Farm Lake.
Signed………………………….. Date …………………………….
All the information submitted will be held on record by the club secretary.
Please post the completed form to; Mr. R.G.Rumney
20, Brook Avenue
Wilnecote
Tamworth
Staffordshire
B77 5BT
Tel No. 01827 – 706637
Mobile No. 07746 004 007
mr.mond@ntlworld.com Website: Raynor-angling.co.uk