MEMBERSHIP APPLICATION/RENEWAL.

NAME :-...................................................................................................................

ADDRESS :-.............................................................................................................

.............................................................................................................

COUNTY :- .................................... POSTCODE :-.........................

TELEPHONE Nos. HOME :-................................................................................

WORK :- ...................................................... EXT. ..............

MOBILE :- ............................................................................

e-Mail :- ……………………………………………………..

MEMBERSHIP REQUIREMENTS. (Please tick)

(please note : to compete in comp. trials/comp. safaris, full membership is reqd)

FULL MEMBER : £ 20.00. ASSOCIATE MEMBER : £ 10.00.

SIGNED : ..................................................................... DATE : ..............................

FOR OFFICIAL USE ONLY.

MEMBERSHIP No. .............................. DATE FEE PAID ..............................

Please return completed form & payment, made out to NI4WDC. to :-

Brian McKay

37 Coash Rd

Ballynakelly

BT71 6JE

………………………………………………………………………………………

MEMBERSHIP APPLICATION/RENEWAL.

NAME :-...................................................................................................................

ADDRESS :-.............................................................................................................

.............................................................................................................

COUNTY :- .................................... POSTCODE :-.........................

TELEPHONE Nos. HOME :-................................................................................

WORK :- ...................................................... EXT. ..............

MOBILE :- ............................................................................

e-Mail :- ……………………………………………………..

MEMBERSHIP REQUIREMENTS. (Please tick)

(please note : to compete in comp. trials/comp. safaris, full membership is reqd)

FULL MEMBER : £ 20.00. ASSOCIATE MEMBER : £ 10.00.

SIGNED : ..................................................................... DATE : ..............................

FOR OFFICIAL USE ONLY.

MEMBERSHIP No. .............................. DATE FEE PAID ..............................

Please return completed form & payment, made out to NI4WDC. to :-

Brian McKay

37 Coash Rd

Ballynakelly

BT71 6JE