Subscriptions
STORNOWAY RUGBY FOOTBALL CLUB
APPLICATION FOR MEMBERSHIP - 2011/2012
NAME
ADDRESS
POST CODE
Date of Birth
E-MAIL ADDRESS
TELEPHONE NO
Type of Membership (Please tick)
Method of Payment (Delete as applicable)
o Full Membership (over 18 & playing rugby) £50 Cheque/Cash/Annual Standing Order
o Full Membership £20 Monthly Standing Order (includes membership fee, match fees, club dinner)
o Associate Membership (over 18 not playing rugby) £25 Cheque/Cash/Annual Standing Order
o Student (over 18)/Unemployed £25 Cheque/Cash
o Junior (under 18) £5 Cheque/Cash
PLEASE INDICATE TYPE OF SUBSCRIPTION PLUS METHOD OF PAYMENT
Return to:
Willie Macleod
Honorary Treasurer
Braeside
Tong
Isle of Lewis
HS2 OHJ
STANDING ORDER MANDATE
The Manager
Bank
Address
PLEASE DELETE AS APPLICABLE
Please debit my account, Number:..............................................with the amount of £.......... on 1st .............., ANNUALLY/MONTHLY (delete to suit) thereafter and credit Stornoway Rugby Club Account No 10040387. Sort Code (83-27-12)
The Manager
The Royal Bank of Scotland
17 North Beach Street
STORNOWAY
HS1 2XH
This order to subsist until cancelled by me in writing
Signed:
Date:
APPLICATION FOR MEMBERSHIP - 2011/2012
NAME
ADDRESS
POST CODE
Date of Birth
E-MAIL ADDRESS
TELEPHONE NO
Type of Membership (Please tick)
Method of Payment (Delete as applicable)
o Full Membership (over 18 & playing rugby) £50 Cheque/Cash/Annual Standing Order
o Full Membership £20 Monthly Standing Order (includes membership fee, match fees, club dinner)
o Associate Membership (over 18 not playing rugby) £25 Cheque/Cash/Annual Standing Order
o Student (over 18)/Unemployed £25 Cheque/Cash
o Junior (under 18) £5 Cheque/Cash
PLEASE INDICATE TYPE OF SUBSCRIPTION PLUS METHOD OF PAYMENT
Return to:
Willie Macleod
Honorary Treasurer
Braeside
Tong
Isle of Lewis
HS2 OHJ
STANDING ORDER MANDATE
The Manager
Bank
Address
PLEASE DELETE AS APPLICABLE
Please debit my account, Number:..............................................with the amount of £.......... on 1st .............., ANNUALLY/MONTHLY (delete to suit) thereafter and credit Stornoway Rugby Club Account No 10040387. Sort Code (83-27-12)
The Manager
The Royal Bank of Scotland
17 North Beach Street
STORNOWAY
HS1 2XH
This order to subsist until cancelled by me in writing
Signed:
Date:
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