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CHESHAM BOIS CATHOLIC PLAYERS by hcj

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									                     CHESHAM BOIS CATHOLIC PLAYERS
                        Registered charity no: 287109 www.cbcp.org.uk
            Membership renewal form: 1st April 2010-31st March 2011
                          Adult: £20, Junior (12-17) £10, Family £50

I wish to renew my membership of the Chesham Bois Catholic Players as an
Adult member* or Junior member (12-17 years)* or as a family membership* (all must have
same surname and reside at the same address)      - *(please delete as applicable and complete
a separate form for each adult or junior member):
Name: Mr/Mrs/Miss/Ms (please delete) …………………………………………………………………………………………...

Date of Birth (if under 18) …………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………………..

……………..……………………………………………………………………………… Post Code: ……………………………………………………

Telephone number: …………………………………………………………………………………………………………….

Email address: ………………………………………………………………………………………………………………….



If applying for, or renewing family membership, please complete the following details for
additional family members (all members must reside at the same address):
Name: Mr/Mrs/Miss/Ms (please delete)           Name: Mr/Mrs/Miss/Ms (please delete)

……………………………………………………………………………………….. ………………………………………………………………………………………..

Date of birth (if under 18):………………………           Date of birth (if under 18):………………………

Name: Mr/Mrs/Miss/Ms (please delete)            Name: Mr/Mrs/Miss/Ms (please delete)

……………………………………………………………………………………….. ………………………………………………………………………………………..

Date of birth (if under 18):………………………           Date of birth (if under 18):………………………



                PLEASE RETURN AS SOON AS POSSIBLE WITH CHEQUE
                            (MADE PAYABLE TO CBCP) TO:
             CBCP Membership Secretary, 3 Stanley Avenue, Chesham HP5 2JF

								
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