120610 YKH Application Form110612 by Ic4bxY9


									     York Knavesmire Harriers – Membership application form
Thanks for expressing interest in our club. Please complete and return this form with payment as explained
below. Once processed, we’ll confirm your membership, tell you how to order your official running vest and
will look forward to welcoming you to our club. If you have any questions, please get in touch.

Alistair McQueen, New Members Secretary (e-mail:ykhnewmembers@yahoo.co.uk)

Your details
First name                                                     Title
Last name                                                      Gender
Address                                                        Date of birth
                                                               Phone number

Post code                                                      Application date
e-mail address

 Second-claim members (if applicable) do not need to pay to join our club, however we do require your
above personal details, your UKA number and the name of your first-claim club.
Other running club(s) details (if applicable)
(i.e. First-claim club and your UKA number)

Any coaching qualifications? (level / event)
How did you hear about our club?

Payment details
Date of joining                                       Cost of annual membership
Jan to April                                          £24
May to August                                         £18
September to December                                 £12
Note: 17 year olds and full-time students pay £12 and pensioners receive a £1 discount.

Method of payment (please tick method chosen)         By cheque
                                                      By online banking

By cheque               Please make cheques payable to ‘YORK KNAVESMIRE HARRIERS’,
                        and send with this completed form to the address below.
Or by online            Please transfer your payment to the following account:
                             Recipient Bank: HSBC
                             Sort code: 40-47-31
                             Account number: 81684094
                             Account name: York Knavesmire Harriers
                             Reference: “YOUR NAME” - Important to include this bit!
                        And also send this completed form to the address below.
Postal address          New Members, 97 Centurion Square, Skeldergate, York, YO1 6DE
e-mail address          ykhnewmembers@yahoo.co.uk

YKH Member Application Form 0612                                                               Page 1 of 1

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