THE NATIONAL LURCHER AND RACING CLUB

PRESIDENT	CHAIRMAN	VICE CHAIRMAN	CLUB SECRETARY	CLUB TREASURER	MEMBERSHIP SECRETARY
Mr K LUXTON	Mr A MART	Mr A LINSEY	Miss S HALLAM	Mr C BEAL	Miss S HALLAM

 

OFFICIAL                                                          MEMBERSHIP APPLICATION FORM

                      In order to continually update our records, please complete the following section.

                      Details are held in strict accordance with the Data Protection Act (1998) and will not be 
                      disclosed to anyone outside the Committee. 
                      When no longer required all documentation containing personal details is shredded.

 

                SURNAME/FAMILY NAMEs….……………………………………………………………………………….

 

                First NAMEs, Titles and dates of birth…..........Title…..…..Name…….…..............…dob…….........

                Title………Name…….............….dob…..….…. …Title………Name……..............…  ..dob………….…

                Title………Name……….………….dob…..….   .…Title………Name……………………..dob………….….

 

                      ADDRESS……………………………………..………………………………………......................…………………………

 

                      POSTCODE……………………..TELEPHONE…………………………………….......................…………….……………

 

                      MOBILE……………………………………………….E-Mail……………………...................……………………………...

 

                I     We have read and endorse the rules and Code of Conduct……………………Date………..........…..

  We are/I am interested in helping at NL&RC Shows and Events             [         ]
 Please tick appropriate Membership Category

 

                       SINGLE @ £7.00        [        ]       COUPLE @ £8.00                               [        ]  

                       FAMILY @ £12.00     [        ]       JUNIOR (Under 16 years) @ £ 3.00    [        ]  

                                                                                                         Total              [            ]
GOODS AVAILABLE VIA POST

 

 STUD IN GOLD PLATE     £  3.00                Temporarily Out Of Stock

 ENAMEL BADGE              £  3.50             Number  [    ]           value                 [            ]

 PEWTER BADGE              £  2.50                 Temporarily Out Of Stock

 NLRC TIE                         £10.00              Number  [    ]           value                [            ]

 ADDRESS BOOK              £  1.25                 Temporarily Out Of Stock

 CAR STICKER                  £  1.00              Number  [    ]           value                [            ]

For Goods Orders Please Add £1.00 P&P      [            ]

 

 LAMBOURN BOOK          £10.00              Number  [    ]           value                [            ]

plus £2.50 P&P (recorded delivery)                 [            ]

               

                             TOTAL                                      [            ]

   

 

                Please Allow 28 Days Delivery Of All Goods And Membership.

 

                Please Make Cheques Payable To N.L.&R.C. and return to

 Membership Secretary NL&RC c/o 20 Songthrush Avenue, Old Basford, Nottingham, NG6 0NH.