Membership Form 2010

Macclesfield Waltonians Annual Membership Form 2010

PLEASE READ CAREFULLY AND NOTE THE CHANGE IN MEMBERSHIP SECRETARY AND ADDRESS FOR 2010
I wish to: JOIN  or REJOIN .
All membership details are required (except for email address) clearly marked using BLOCK CAPITALS ONLY.

MEMBERSHIP NO.

(REJOINING ONLY)

FIRST NAME

LAST NAME

ADDRESS

TOWN

COUNTY

POST CODE

DATE OF BIRTH

(DD.MM.YYYY)

EMAIL ADDRESS

(name@youraddress.com)

CONTACT NUMBER

Failure to complete all sections of this form and sending a S.A.E full may result in your membership not been processed.

FEES ENTREE MEMBERSHIP

SENIORS (3 ROD) £10  £40 

SENIORS £10  £33 

O.A.P £10  £20 

LADIES £10  £20 

JUNIOR (12 - 16) £10  £20 

If you require additional tickets, please tick the box below.

(Only available with Senior, OAP and Ladies memberships)

NON-FISHING GUEST TICKET £5 

(Only available with Senior, OAP and Ladies memberships)

If you require a night fishing permit, please tick the box below.

NIGHT PERMIT (Herons Pool ONLY) £10 

(Only available with Senior, OAP and Ladies memberships)

Please SELECT ONE of the following that best describes your style of fishing?

Carp fishing  Bream Fishing  All Species 

Please return a STAMPED ADDRESS ENVELOPE with your fees to:

Mr Steve Hicks, Membership Secretary

13 St georges Street Macclesfield Chesire SK11 6TG

Fax: 01625 429888, Email: membership@waltonians.co.uk

Cheques made payable to: Macclesfield Waltonians A.S.


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