STORNOWAY RUGBY FOOTBALL CLUB

 

APPLICATION FOR MEMBERSHIP - 2009/2010

 

NAME
ADDRESS
POST CODE
Date of Birth (Students Only)
E-MAIL ADDRESS
TELEPHONE NO’s

 

                Type of Membership (Please tick box)                                             Method of Payment (Delete as applicable)

           

o        Full Membership               £30                               Cheque/Cash/Standing Order

o        Family Membership           £30                               Cheque/Cash/Standing Order

o        Coach/Committee              £20                               Cheque/Cash/Standing Order

o        Associate Membership       £10                               Cheque/Cash/Standing Order

o        Student/Concession            £10                               Cheque/Cash

o        Junior (Over16, U18)         £10                               Cheque/Cash

o        Midi S1-S4                         £5                                Cheque/Cash/Standing Order

o        Mini (Primary)                    £5                               Cheque/Cash/Standing Order

o        Senior Citizen                £FREE                              

o        Surcharge (after 1st Aug)    £10                             Cheque/Cash

 

PLEASE INDICATE TYPE OF SUBSCRIPTION PLUS METHOD OF PAYMENT

 

Return to:

Kevin McAndie

 Secretary

Raeburn, 51 Crossbost

Isle of Lewis HS2 9NP

 

 

STANDING ORDER MANDATE

PLEASE COMPLETE AND HAND IN TO YOUR BANK

 

The Manager

 

Bank

 

Address

 

PLEASE DELETE AS APPLICABLE

Option 1

 

Please debit my account, Number:…………………………… with the amount of £…….. on 1^st .............., ANNUALLY/MONTHLY (delete to suit) thereafter and credit Stornoway Rugby Club Account No 00702397.  Sort Code (80-09-73)

 

 

 

The Manager

The Bank of Scotland

47 Cromwell Street

STORNOWAY HS1 2DE

 

This order to subsist until cancelled by me in writing

 

Signed:                                                                                      Date: