MEMBERSHIP

APPLICATION

FORM

Please complete in BLOCK CAPITALS

Details will only be used in relation to Priorslee Lions Chess Club, and will NEVER be divulged to any 3rd party.

Personal Details
Name Address Town / City County Telephone No. E-mail address Postcode Mobile No.

Club subscriptions for 2012-13 are 12 adults and 5 juniors (U18)

In addition to this there is the fee for Membership of the ECF (English Chess Federation), depending on how many graded games you intend to play during the year. See "ECF Membership Scheme - A Quick Guide for Players" for full details. Please note that membership to the ECF is mandatory if you play more than 3 graded games.

ECF Membership
Are you currently a Direct Member of the English Chess Federation? (Y/N) If YES, then please enter your ECF Membership number here . . . . . . . . . . . . . . Just pay 12 Club Subscription (5 Juniors) and renew your ECF Membership when it lapses If NO, please tick the relevant box to indicate which ECF Membership you require
These prices INCLUDE the relevant ECF membership (Junior prices in brackets)

BRONZE 24 (13)

SILVER 30 (17)

GOLD 39 (26)

Please make cheques payable to Priorslee Lions Chess Club and send to:G White, 20 Kingfisher Way, Apley, Telford, Shropshire. TF1 6FW

The Lion, Shifnal Lane, Priorslee. TF2 9NN

Contact: Gary White 01952 258715 or garymw@talktalk.net
Priorslee Lions Chess Club 2012, All Rights Reserved

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