Candidates must deposit membership fees at the time this form is submitted. In the case of non-acceptance, fees will be refunded.
(PLEASE PRINT NAME & ADDRESS)
Candidates Full Name_______________________________
______________________________ Postcode ________
Being upwards of eighteen years of age is desirous of belonging to Bloxworth Village Club. I wish to propose him/her from personal knowledge as a proper person to become a member.
_____________________________ Postcode ________
Dated this day ________ of _______________ Year 20____
I the undersigned, concur in the above proposal:
____________________________ Postcode ________
DECLARATION TO BE SIGNED BY THE CANDIDATE:
I undertake to abide by the rules and by-laws of the above Club so long as I remain a member and use my best endeavours for the furtherance of its objects.
Have you been a member of another Club? Yes/No.
If Yes, name of Club______________________________
INTERNAL USE ONLY
Received £______ Date ______________ No. __________