please print clearly
Name
Address
Postcode Tel: E-Mail
type of membership required
single £7.00
partnership £14.00
partnerships at same address £10.50
senior citizens £5.00
disabled £5.00
juvenile FREE
status - champion - intermediate - novice - beginner - juvenile
(please delete as appropriate)
please return to subscription secretary: Mr Brian Whitlock , 32 Stacey Ave , Wolveron , Milton Keynes , MK12 5DL .
E-Mail b.whitlock@hotmail.co.uk TEL : 01908 312860
Please make all cheques P/O`s payable to LABS and please enclose a S.A.E for a receipt
For secretaries use only
Membership fee paid Receipt no: Date: