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SONNING HOCKEY CLUB MEMBERSHIP FORM 2009 - 2010 Please complete this form and return directly to me (details below) with your fee, or hand in at the club, over the bar, FAO me. DO NOT put in the treasurer’s box or give to your Captain. Please help your club by paying your membership fee promptly. FORENAME SURNAME ADDRESS POSTCODE HOME TEL EMAIL ADDRESS WORK TEL MOBILE Date Of Birth MAIN CLUB MEMBERSHIP NUMBER (to be assigned if new member) SPOUSE / PARTNER / CO-HABITEE OCCUPATION / *COURSE DETAILS with end date In case of illness or injury whilst taking part in club activities please give alternative contact information NAME HOME TEL ADDRESS MOB TEL The following information is helpful for our records especially when applying for accreditation and/or funds to help our club ETHNICITY Do you have a disability? White: British Irish Other Mixed: White & Black Caribbean White & Black African Please state if any hockey coaching, hockey umpiring or PE Mixed: White & Asian Other qualification held Asian: Indian Pakistani Bangladeshi Other Black: Caribbean African Other Chinese I hold an up to date CRB check issued through Other Please highlight or circle membership type – all memberships include Main Club fee Please deduct £39 if you pay your main club fee by Payroll or Standing Order or you are a 1. Full Membership £139 member through your spouse/partner/co-habitee. 2. Associate Membership £89 Associate membership is at the discretion of the committee. 3. Full time student (over 18) £57 *Please give details above 4. Registered Unemployed £57 Please highlight or circle your method of payment 1. Cash 2. Cheque 3. Bank Transfer payable to Sonning Hockey Club RCB Sonning Hockey Club (please write your cheque card number on Sort code 30-91-11 Account Number 03840865 back of cheque) reference SUBS+first name+last name+postcode Players will not be entitled to play in matches if subscriptions remain unpaid after 31st October Match fees will apply – please see fixture card or website for details Thank You for your prompt payment, Membership Secretary – Liz Weeks, 145 Woodward Close, Winnersh, Wokingham, Berks, RG41 5UT tel 0118 978 4575 mob 0789 422 1791 firstname.lastname@example.org
"SONNING HOCKEY CLUB MEMBERSHIP FORM 2009 - 2010 - DOC"