Membership application form by 18wg671c

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									                                                                            SOUTH CHESHIRE RIDING CLUB

                                                       MEMBERSHIP APPLICATION / RENEWAL FORM (2012)
                                                                There are four types of membership and subscription rates as follows:


Riding Member                                   £24                 Dual Membership £39 (2 members of same family living at same address)
Non-Riding Member                               £10                 Family Membership £48 (More than 2 members of same family living at same address)
Please note that renewal’s paid on or before 21/10/07 will be at last year’s rate of £20 per individual or £35 for dual and £45 for families

SUBSCRIPTIONS are due annually
                                                                                                                                                 Type of                 Member of
NAME’s:                                   Please PRINT clearly                                                                Qualifications                Other Club   Teams
Mr/Mrs/Miss Ms                                                                                                                                                                       YES/NO*
Mr/Mrs/Miss Ms                                                                                                                                                                       YES/NO*
Mr/Mrs/Miss Ms                                                                                                                                                                       YES/NO*
Mr/Mrs/Miss Ms                                                                                                                                                                       YES/NO*

Please state after names if any of the above hold a current First Aid certificate, any Pony Club, Riding Club or BHS qualifications , belong to another
riding club, (if so please state which one), or wish to represent club in teams.

ADDRESS:

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

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

POST CODE: Tel. No. (Incl. STD code)...........................................................

E-mail address: ……………………………………………………………………………………….……………… Mobile: …………………………………...

DUTY ROTA:

It is a condition of membership that all Club members are required to assist with the efficient running of club functions, or provide another person
to serve on their behalf. You could be asked more than once in a twelve month period. A list of members’ telephone numbers is enclosed to
enable to you find a substitute if necessary.

I agree to abide by the rules and information of South Cheshire Riding Club and make application for the following type of membership and
enclose:

£______ to cover the cost of Riding/Non-Riding/Dual /Family Membership* Please delete accordingly.

Signature of Applicant/Renewing Member ….......................................................................
Date of Application/Renewal                   ………….................................
Name of a current member of South Cheshire Riding Club who
Has agreed to propose the above named person/s membership application:


Cheques: Please make payable to “South Cheshire Riding Club” and send, together with this completed application form to: Sally Baker, 55 The
Burgage, Eccleshall, Staffs, ST21 6DR  svbaker@live.co.uk     07817 636297

(Tick this box if you don’t agree to our name & phone number being made available to Club members)




For Office Use Only:
Membership Number                         ......................
Date Application Received                 ......................
Date Accepted                             ......................
Letter of acceptance sent                 ......................
On mailing list/e-mail                    ......................

								
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