www.hullavington.info

 

Kington St Michael Club & Institute
Affiliated to the Working Men’s Club & Institute Union, Reg no 477

Telephone 01249 750336

  

MEMBERSHIP APPLICATION FORM


Block letters please.

 

NAME…………………………………………………………………….

 

ADDRESS……………………………………………………………….

 

………………………………………………….....................................

 

…………………………………………………………………………….

 

POST CODE……………………… TEL NO…………………………..

 

Date of birth: …………………………………………………………...

 

MOBILE NUMBER………………………………………………………

 

E-mail address………………………………………..........................

 

OCCUPATION/SKILLS…………………………………………………

 

SIGNATURE……………………………….. DATE……………………


By signing you are agreeing to abide by the Club Constitution, which you will receive when your membership has been ratified by the Committee. 


PROPOSER’S NAME
………………………..SIGNED………………….

PROPOSER’S MEMBERSHIP NO………………

 

SECONDER’S NAME………………………...SIGNED…………………
SECONDER’S MEMBERSHIP NO
……………….


The proposer and seconder must have been members themselves for 6 months.  The membership fee of £5 must accompany this application.  The applicant becomes a temporary member until the Committee ratifies this application and a membership card is issued, which will then be available to collect from the Club.

 

All sections in red must be completed in full.