Membership Application Form

Candidates Name*

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Date of Birth*

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Address and post code*

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Contact number*

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E-mail*

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The e-mail address is invalid

New to area- Yes/No*

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Proposed By and Membership number*

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Seconded By and Membership number *

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Date of application*

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Membership fee £20

Senior Citizens (60+) £10

Payments via bank transfer send to bank: Name : Six In One Club account number : 81458396 sort code : 40-44-20 with reference of your name (Please tick yes when you pay the money into the bank account*

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OR via PayPal (Friends & Family) to - sixinoneclub@gmail.com

I hereby agree that this data will be stored and processed for the purpose of establishing contact. I am aware that I can revoke my consent at any time.*

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