APPLICATION FOR MEMBERSHIP

The Secretary
Chaguaramas Sports Club
Western Main Road
Chaguaragus

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FIRST NAME MIDDLE NAME SURNAME

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hereby apply for Membership of the Chaguaramas Sports Club and agree, if accepted, to abide
by the rules and regulations. I enclose a membership fee of $50.00.

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D DM M Y Y
Telephone Number:

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Date of application: ………………….. Signature:
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Proposed by: ………………………………

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Address of proposer: …………………………………………………………………………
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FOR OFFICIAL USE