PENKRIDGE PHOENIX CLUB
MEMBERSHIP RENEWAL/APPLICATION SEPT 2018-AUG 2019
I/We wish to renew my/our membership (or become new members)
delete as applicable
Name/s_______________________________________________________
Address:-_____________________________________________________
_____________________________________________________________
Telephone No:________________________________________________
e-mail address________________________________________________
I/We enclose cheque for £___________(subscription £4 per member)
Subscriptions are due by 1st September. Please complete the above and
return, together with a stamped, addressed envelope, to Membership
Secretary:
Mrs. Judy Chivers Please make cheques payable to
5 Wiscombe Avenue Penkridge Phoenix Club
Penkridge
Stafford
ST19 5EH
PLEASE NOTE:
The details above will be kept on record by Penkridge Phoenix Club
and in order to comply with Government Data Protection Regulations,
you are asked to sign below to signify your consent to this.
Signature…………………………………………………………………….
Should you wish to withdraw your consent at any time, please contact
The Membership Secretary and your details can be removed from our
Records.
