COLERNE CONSTITUTIONAL CLUB

MEMBERSHIP APPLICATION FORM

Membership Type (Tick box):
Junior
(2.50)

Member

(5)

(Fee to be paid on application)

Name:
...
.. (Mr/Mrs/Mstr/Miss/)
Address: ..
.
Telephone Number:

IN SIGNING THIS FORM, YOU CONFIRM THAT YOU HAVE READ AND UNDERSTOOD THE
CLUB RULES/CODE OF CONDUCT (A COPY OF WHICH IS ON THE CLUB NOTICE BOARD),
AND THAT YOU AGREE TO BE BOUND BY THESE AT ALL TIMES.
Signed:

Proposed by: Signed:

(Block Capitals)
Seconded by:
.. Signed:

(Block Capitals)
(Proposer and Seconder must be Members of at least 6 months standing)
This application, which is to be forwarded to the Committee Member responsible for
Membership, will be considered at the next scheduled meeting of the Club Committee.

(This slip is to be detached and handed to the applicant)

ACKNOWLEDGEMENT OF APPLICATION AND RECEIPT OF FEES PAYABLE (WHERE

APPLICABLE)

Pending consideration by the Club Committee, .. has

applied for Membership of the Colerne Constitutional Club, and has paid the appropriate
Membership Fee (where applicable).
Fee Paid: .
Date: ..
.

Signed: