Raynor Angling Club 

Application for membership

    Full Name         ...............................................................

    Address            ..............................................................

                             ...............................................................

                             ..............................................................

    Post Code         ...............................

    Telephone Number including dialing code     ..............................

     Email Address             .................................................................

     Current Vehicle Make  ............................ Colour  ..............  Registration Number..................                                        

     Date of Birth    ....................      I am applying for    Full / Senior Citizen / Junior Membership  

     Are you a member of any angling team   Yes / No    if Yes which one ...............................

     Are you in receipt of any sponsorship from any source   Yes / No If Yes who .............................

     I enclose my cheque  for £.......... as my membership fee made payable to "Raynor A.C."and      a passport sized photograph of me

 

     Please include an A5 size stamped addressed envelope with 2 x First class stamps for reply

     

     Full membership fee                  £25:00

     Senior Citizen membership fee  £19:00

     Junior membership fee              £15:00

 

     Subject to my application being approved I agree to abide by the club rules and all notices

     and instructions in force by Garlands Shooting Grounds.and at Camp Farm Lake

    Signed .................................................    Date ...........................

     All of the information submitted will be held on record by the club secretary

     Please post this completed form to   Mr. R.J.Mellor

                                                             Raynor Angling Club

                                                             15 Sycamore Avenue

                                                             Newhall

                                                             Swadlincote

                                                             Derbyshire

                                                             DE11 0NJ                

 

      Telephone 01283 212180        Mobile 07951175715         

 

       Email:  rjmellor@talktalk.net

      Website   http://www.raynor-angling-club.co.uk