EAST ANTRIM RAMBLING CLUB

MEMBERSHIP REGISTRATION FORM

Name

 

 

Address and Postcode

 

 

Email address

 

 

Telephone: Home

Mobile

 

 

 

How did you hear about the Club?

 

 

 

 

The following additional information is required by Sport NI (in confidence) to enable monitoring under Sport NIís Active Clubs Programme.

 

Please place x in the appropriate box, where appropriate

 

Male

 

Female

 

 

Ethnic Origin

 

 

Age Range††

18-25

 

26-40

 

41-59

 

60+

 

 

Do you consider yourself disabled?††††††††††

Yes

 

No

 

 

If you answered yes could you expand on this?

 

Mobility

 

Learning

 

Hearing

 

Visual

 

Other

 

 

If other please specify

 

 

 

 

PLEASE PASS THE COMPLETED REGISTRATION FORM (BY HAND, POST OR EMAIL) TO THE CLUB SECRETARY

 

CLUB SECRETARY

Teresa Malone

31, Collinbridge Gardens,

Glengormley,

Newtownabbey

BT36 7SU

Mobile: 07896 330095.

Email: tmalone31@hotmail.com

 

PAYMENT OF THE ANNUAL SUBSCRIPTION FEE

 

The annual subscription fee is currently £20 per member. The subscription fee is agreed by members at the Annual General Meeting in September.

Payment can be made in one of the following ways:

(1) Cheque made payable to East Antrim Rambling Club and passed to the Treasurer,

(2) Cash payment to the Treasurer and

(3) On-line Transfer (the clubís bank details are as follows: Sort Code: 09-01-29 and Account Number: 00584559.

 

CLUB TREASURER

 

Alastair Jack, 12, Glencroft Road, Newtownabbey BT36 5GD.

 

Tel: 02890 835956

 

Mobile: 07597 995290.††

 

Email: alastrjack@aol.com

 

Alastair will provide a receipt for your payment (usually by email).

 

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