Renewal Form - Norwegian Buhund

Transcription

Renewal Form - Norwegian Buhund
NORWEGIAN BUHUND CLUB
Patron: His Excellency Mr Kim Traavik, Norwegian Ambassador
Hon. Chairman: Di Stirling Hon. Secretary: Camille Pentland Hon. Treasurer: Sue Cale
MEMBERSHIP RENEWAL FORM
Membership runs from 1st January to 31st December each year.
NAME(S): ………………………………………………………………………………………………………………
(Please PRINT)
ADDRESS: …………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………
POST CODE : …………………………………………………………
TELEPHONE: …………………………………………………………
EMAIL: …………………………………………………………………………………………………………………………………………………………………….
Please read and sign:
I have read the Rules of the Norwegian Buhund club, together with the current Code of Ethics and the Rules of the
Rescue Scheme, and I agree that my membership of the Norwegian Buhund Club is conditional upon my
observing them.
Membership fees:
SIGNED: ………………………………………………………………..
DATE: ……………………………………………………………………
Single £10.00
Joint £15.00
Senior – 60 yrs (Single) £6
Senior – 60 yrs (Joint) £10.00
Junior (Under 16 yrs) £6.00
Joint membership can be any two persons in partnership
Cheques/PO made payable to: ‘Norwegian Buhund Club’
Please send to:
Hon. Secretary
Mrs Camille Pentland
22 Glanhowy Road
Wyllie, Blackwood, Gwent
NP12 2HN
Email: [email protected]
This information will be kept on computer and sent to the Kennel Club if required.
STANDING ORDERS - You can arrange with your bank for a standing order:
The details you will need are:
Lloyds TSB, Station Road, Ashington.
Sort Code 30 95 76
Account Number 21787160