LANCASHIRE & MERSEYSIDE FIELD TRIAL SOCIETY I.D. Number 677 MEMBERSHIP JOINING FORM Please complete the membership joining form below and send to: Membership Secretary; Mr Paul Brooks, 1 Fantail Close, Thornton Cleveleys, Lancashire, FY5 5FY5 paul.brooks19@btinternet.com Title ………………………. Name………………………..……………………………………………………………………………………………………………… Address………………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………….. Postcode ……………………………………………… Home Telephone Number ………………………….…………… Mobile ……………….......................................................... Email address………………………………………………………………………………………………….. Signed………………………………………….. Date…………………………………………Single / Joint If accepted by the society I agree to abide by the Rules and Decisions made by the committee Applications must be submitted with signatures of a proposer and a seconder who are members of the Society. Applications without a signature will not be processed by the committee Proposer's Signature: ………………………………………………… Proposer's Name:…………………………………………………… Seconder's Signature: …………………………………………………Seconder's Name:…………………………………………………… Annual Subscription is payable 1st January each year: Single £10, Joint £12, Junior £1 Joining Fee: Single £10, Joint £12, Junior £1 (i.e. Total payable in the year of joining is £20.00 single/£24.00 joint/£2 junior) Please make cheques payable to "L.M.F.T.S" Subscription enclosed £……………………. If you wish to pay by Bankers Standing Order please indicate with a cross here ……… and post this half of the form to Membership Secretary at the above address. Subscriptions are payable on the 1st January annually. A member whose subscription has lapsed will not be entitled to any of the privileges of membership and if the member fails to pay the outstanding subscription within two months (i.e. by 1st March), his or her name shall be automatically erased from the register. Acceptance back as a member of the Society will be dependent upon a new application and payment of back arrears LANCASHIRE & MERSEYSIDE FIELD TRIAL SOCIETY I.D. Number 677 JOINING FORM To The Manager (As details as in your cheque book) Name of Bank: …………………………………………………………………………………………………………………………………….. Full Bank Address: ……………………………………………………………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………………………………………………………. Postcode: ……………………………………………………………… Please Pay from My/our Account Sort Code: ………. ………. ………. Acount Number ………………………………………….. Account Name: …………………………………………………………………………………………………………………………………….. Amount: £ ………………………………… Single £10, Joint £12, Junior £1 Starting: 1st January 20… and Frequency: ANNUALLY, on the 1st JANUARY, thereafter until further notice, to: Account at Bank/Branch: The Royal Bank of Scotland Chorley Branch 56 Market Street, Chorley Lancashire PR7 2SD Sort Code: 16-32-10 Account No.: 12879661 Signatures(s) ……………………………………………….. Date:………………………………….. ……………………………………………….. Date:………………………………….. PLEASE SEND THIS MANDATE TO YOUR OWN BANK AS YOU HAVE WRITTEN ABOVE