I wish to become a member of the WOLSEY ROAD CLUB
Title ________________________________________________________________
Name (In Full) ________________________________________________________
Address ______________________________________________________________
Postcode_____________________________________________________________
Date of Birth: ___________
Tel: ___________________
Email: _________________
Subscription Category (Please Tick):
|
Category |
Comments |
Cost |
|
Senior ___ |
Over 18 years |
£10 |
|
Junior ___ |
16 – 18 years |
£5 |
|
Juvenile ___ |
12 – 16 years |
£5 |
|
Infant ___ |
Under 12 years |
Free |
|
Second Claim ___ |
|
£5 |
Please make cheques payable to “Wolsey Road Club”
Send application form and cheque to:
The Secretary:
Mrs Maureen Nichols
197 Britannia Road
Ipswich. IP4 5HE