Active Hampshire Logo
APPLICATION FOR FULL MEMBERSHIP
Prospective members of Active Hampshire must have attended at least three activities and be known to two committee members before an application for full membership can be considered.
Mr/Mrs/Ms Forenames Last Name

Address
Home Phone
Work Phone
Mobile Phone
Email Address Date of Birth ___/___/19___ Sex M / F
One or more CSV contact lists may be produced during the year and sent to all FULL members of Active Hampshire. The details that are included with your name are address, email and home phone number. It is your responsibility to inform the Membership Secretary before publication if you would like any of your details removed from such a list.

Member of another IVC Affiliated Club ? Yes / No if yes, which?
Three events you have been to and obtained officer signatures at those events:
1. Officer Signature: Date: ___/___/____
2. Officer Signature: Date: ___/___/____
3. Officer Signature: Date: ___/___/____

PLEASE UNDERLINE BELOW ANY ACTIVITIES BELOW YOU ARE PREPARED TO ORGANISE.
ARTS & INTERESTS
Cinema
Theatre/Drama
Books/Literature
Visual Arts
Museums/Galleries
Buildings / Architecture
Arts and Crafts
Clothing and Fashion
Visiting/Discovery
OUTDOOR
Camping/Hostelling
Travel (UK & Abroad)
Walking/Climbing
Water Sports
Equestrian
Flying & Aviation
Motor Sports
Snorkelling/Sub-Aqua
Pitch & Putt (Golf)
SPORT
Badminton
Squash
Tennis
Cycling
Swimming
Athletics
Cricket
Football
Rounders
MUSIC & DANCE
Barn Dance
Modern Jazz Jive
Jazz, Blues, & Soul
Classical/Opera
Pop Music
Nightclubs/Discos
Karaoke
Comedy Clubs
Concert Tours
LEISURE
Dining Out/Dining In
Pub Nights
Games/Quiz Nights
Skittles Evenings
Ten Pin Bowling
Ice Skating/Skiing
Treasure Hunts
House Parties
Disco/Music Cruises
Data Protection Act: The information supplied on this form will be stored on a computer to facilitate bulletin distribution and club administration. Your signature below will be taken as permission for this.

I/we hereby apply for Membership of Active Hampshire. I/we agree to abide by the rules of the club as laid down in the Constitution and Club Rules of Conduct, which are available for inspection on the Active Hampshire web site at http://www.ActiveHampshire.org.uk and on application to the Secretary.

I/we will endeavour to organise at least two events per year towards the club programme.

I/we enclose the annual subscription of 15.00 GBP per person and understand that this will be returned if this application for membership is not accepted by the Committee of Active Hampshire. I/we acknowledge that Active Hampshire reserves the right to refuse this membership application without assigning any reason.

Signed Date
Please print, sign and return this form to:
Ian McCormack (Active Hampshire Membership Secretary)
11 Taylor Drive, Bramley, Tadley Hants RG26 5XB
Tel: (01256) 886066