|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.|
|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
Buildings / Architecture
Arts and Crafts
Clothing and Fashion
Travel (UK & Abroad)
Flying & Aviation
Pitch & Putt (Golf)
MUSIC & DANCE
Modern Jazz Jive
Jazz, Blues, & Soul
Dining Out/Dining In
Ten Pin Bowling
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 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.
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