MEMBERSHIP RENEWAL/APPLICATION SEPT 2018-AUG 2019

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.

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