Northampton West End Bowls Club

Mendip Road, Northampton, NN5 6BA

Telephone:  01604 583702

 

APPLICATION FOR MEMBERSHIP

 

Title;                           …………………  

 

First name:                …………………….. ………………………………

 

Last name:                 ………………………………………………………

 

Address:                    …………………………………………………………………………

 

…………………………………………………………………………………………………

 

Post Code:     …………………..

 

Home Tel.  No:          …………………………….     Mobile Tel.  No:         ………………………..

 

email address:           ………………………………………………………………………….

 

Date of birth (If under 18):   ………………………..

 

 

Signature:      ………………………………….                      Date:   …………….................

                        (parent/guardian if under 18)

 

Proposer:       ………………………………………………..

 

Seconder:      ………………………………………………..

 

Name of previous Club:       ……………………………………………………………...

 

Please return completed form as soon as possible to:

 

Mr R Summers  (Hon Secretary)

180 Weedon Road

St James

Northampton

NN5 5DA                    (01604 757854)

 

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

            F  O  R   S  E  C  R  E  T  A  R  Y’S  U  S  E   O  N  L  Y:

 

The Northampton West End Bowls Club have accepted/ not accepted*

 the above application     

 

* delete as appropriate

 

Signed: ……………………………………………….       Date: …………………………