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APPLICATION FOR TRIAL MEMBERSHIP |
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This form entitles the prospective member to take part in all
Basingstoke & North Hampshire IVC activities subject to any
restrictions / limits applied by the activity organiser(s).
Trial Members are regarded as "guests" where
priority is given to members and/or differential charges have
been notified for an activity. This Trial Membership
carries no voting rights within the Club and is valid for up to
three months from the date of receipt of this form.
This form must be printed, completed, signed and returned to the BNHIVC Membership Secretary in order to comply with the Data Protection Act. |
| Mr/Mrs/Ms | Forenames |
Last Name
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| Address | ||
| Home Phone | ||
| Work Phone | ||
| Mobile Phone | ||
| Email Address | Date of Birth ___/___/19___ Sex M / F | |
| A membership list is produced several times a year, only your name from the above will be included | ||
| Member of another Inter-Varsity Club ? Yes / No | if yes, which? |
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General Interests & Hobbies
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| Occupation | University / College |
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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 enclose with this application for Trial Membership a cheque for £10.00 payable to BNHIVC. I/we hereby apply for Trial Membership of the Club for a period not exceeding three months from the date below. I/we agree to abide by the rules of the club as laid down in the Constitution and Club Rules of Conduct, which is available for inspection on the BNHIVC web site at http://www.bnhivc.org/defaultAbout.htm and on application to the Secretary. I/we understand that this Trial Membership is valid for a period not exceeding three months and that it may be terminated by Basingstoke & North Hampshire IVC without notice. I/we acknowledge that Basingstoke & North Hampshire IVC reserves the right to refuse my/our membership application without assigning any reason. |
| Signed | Date |
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Return form to:
Julie Stopps, BNHIVC Membership Secretary (membership@bnhivc.org) 68 Foxdown, Overton, Hampshire RG25 3JQ (0773 339 5515) |
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