EMWPCA MEMBERSHIP 2008
NAME____________________________________________________________________________
ADDRESS _________________________________________________________________________
___________________________________________________________________________________
_________________________________________________POST CODE ______________________
TELEPHONE NO. (INC. STD CODE) __________________________________________________
MOBILE No._______________________________________________________________________
Sections Bred/Stud Prefix______________________________________________________________
E-mail address _______________________________________________________________________
SIGNATURE _______________________________________________________________________
FEE £10 PER ANNUM, RENEWAL DATE 1ST JANUARY ANNUALLY.
I enclose a cheque payable to EMWPCA
MEMBERS ARMBAND REQUIRED Y/N - £1.50 each
JUNIOR MEMBERSHIP £1 per Junior (only available in conjunction with adult membership)
Name ______________________________________________________________________________
Date of birth ________________________________________________________________________
Junior members armband Y/N - £1.50 each
PLEASE RETURN TO:- Jenny Chappell, 42 Hardwick Village, Clumber Park,
Worksop, Notts S80 3PD
Tel. 01909-485374 It would be helpful and save us money if
you could enclose a SAE
OFFICIAL USE:
MEMBERSHIP NO. ____________________JUNIOR MEMBERSHIP NO. _________________
DATE CARD SENT _____________________DATABASE UPDATED_______________________