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Application For Single Association

 

Surname:


Forename:



Address:


Post Code:


Telephone Number:


Date Of Birth:


Email Address:



MR
MRS
MISS
MS


Have you been refused or had you membership revoked from any other Club?


Yes
No


If yes, name of Club and details:



I hereby agree to abide by the rules of the Association and certify that the above information is correct.




If any of the information given is false it will result in automatic cancellation of membership.