THE WELSUMMER CLUB

MEMBERSHIP APPLICATION

Name
Address




Postcode		Telephone	*
eMail Address	*
	*(These two details are entirely optional.)

If you want to make alterations to your address, you can use this form to do that. Fill in your new address but please be sure to put a tick in the box here.

YOU CAN FILL IN THIS FORM THEN PRINT IT OFF AND SEND IT, WITH YOUR PAYMENT, TO THE CLUB SECRETARY:
Mr. G H Johnson, Aston Mews, Coppice Green Lane, Shifnal, Shropshire, TF11 8TP, UK

Cheques for £7.50 should be made payable to The Welsummer Club. If you are not able to pay in GBPs please send the equivalent amount in your own currency plus 10%.