Club West renewal form (full rate)

Received in office___________

First Name(s) ________________________ Last name ____________________________________

Address (if changed)

___________________________________________________________________________

___________________________________________________________________________

________________________________________________________Postcode____________

email address (if changed)

_______________________________________

Phone nos (if changed)

landline____________________ mobile __________________________

Cheque enclosed NOT STAPLED:

____ £55 for 12 programmes by post (& email if required)

____ £45 for 12 programmes by email only