Evesham & District Music Club
MEMBERSHIP APPLICATION
2010-2011
Name…………………………………….Mr/Mrs/Ms
Address………………………………………………
…………………………………………………………
…………………………………………………………
Postcode………………………………………………
Telephone……………………………………………
Email……………………………………………………
Address………………………………………………
…………………………………………………………
…………………………………………………………
Postcode………………………………………………
Telephone……………………………………………
Email……………………………………………………
PLEASE SEND
Signed……………………………………………….
Full
Memberships
@£55
Senior Concessions @£50
Student Memberships @£5
TOTAL
Senior Concessions @£50
Student Memberships @£5
TOTAL
Signed……………………………………………….
Please return
this form to
Please enclose a cheque made payable to "Evesham & District Music Club" and a stamped/addressed envelope.
Robert Bomford
The Barn
Bevington Hall Farm
Iron Cross
EVESHAM
WR11 8SJ
The Barn
Bevington Hall Farm
Iron Cross
EVESHAM
WR11 8SJ
Please enclose a cheque made payable to "Evesham & District Music Club" and a stamped/addressed envelope.
Your details will be used in
relation to your membership of Evesham and District Music Club
and will not be passed to any third party without your consent.
and will not be passed to any third party without your consent.
