THE NATIONAL LURCHER AND RACING CLUB

                       PRESIDENT           CHAIRMAN         VICE CHAIRMAN         CLUB SECRETARY      CLUB TREASURER       MEMBERSHIP SECRETARY

                   MR M ALDHOUS       MR N VARNEY      MISS S McDOWELL       MRS L VAUGHAN      MRS S BRAITHWAITE            MISS H SWAN

 

 

                                                                                                                                        OFFICIAL APPLICATION/RENEWAL FORM

                        

                                FULL NAME/NAMES   ……………………………………………………  SURNAME…………………………………………

                           

                                ADDRESS   …………………………………………………………………………………………………………………………………………………

                        

                                 ………………………………………………………………………………………….   POSTCODE…………………………………………

                        

                                TELEPHONE   ………………………………………………………………   MEMBERSHIP NUMBERS……………………………………………..

 

                            MEMBERSHIP RENEWAL                    [          ]

 

                              SINGLE MEMBERSHIP @ £7.00                      [           ]

                              COUPLE MEMBERSHIP @ £8.00                     [           ]

                              FAMILY MEMBERSHIP @ £12.00                    [           ] PLEASE INCLUDE ALL NAMES

                              JUNIOR MEMBERSHIP  @ £ 3.00                    [           ] UNDER 16

 

      GOODS AVAILABLE VIA POST

           STUD IN GOLD PLATE               £3.00           [           ]

           ENAMEL BADGE                       £3.50           [           ]

           PEWTER BADGE                       £2.50           [           ]

           NLRC TIE                               £10.00          [           ]

           ADDRESS BOOK                       £1.25           [           ]

           NOTE BOOK                            £0.75           [           ]

          

           SPECIAL EDITION LAMBOURN BOOK  £10    [           ]          

        

            

            TOTAL                                        [           ]

 

                       PLEASE MAKE CHEQUES PAYABLE TO N.L.&R.C. FOR GOODS ORDERS  PLEASE ADD £1.00 P&P. 

FOR OR             FOR ORDERS OF THE LAMBOURN BOOK PLEASE ADD £2.50 FOR P&P

 

                       PLEASE ALLOW 28 DAYS DELIVERY OF ALL GOODS AND MEMBERSHIP.

 

R                                                                          RETURN TO

                                                            MEMBERSHIP SECRETARY.

                                                                58 WESSINGTON LANE,

                                                                        S.WINGFIELD

                                                                          ALFRETON.

                                                                            DERBYS

                                                                           DE55 7NB

 

 

 

 
 
 
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