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