Club Membership costs £5 per year and there is an initial application fee of £10.

Please print this form and complete it with your details, then send it to Alan Jacob, Membership Secretary, Leelands, Stancombe Lane, Shalden, ALTON, Hampshire, GU34 5TA enclosing a cheque payable to Alton CC for £15 to cover the first year's subscription and the initial application fee.

Surname _______________________________

First name ______________________________

Date of Birth_____________________________

Title_________________________ Mr/Mrs/Ms/Dr.

Address 1 ______________________________

Address 2 ______________________________

Address 3 ______________________________

Address 4 ______________________________

Address 5 ______________________________

Home Phone ____________________________

Day time Phone __________________________

Email __________________________________

Signed _________________________________

Date ___________________________________

I agree to the above details being held on the Club's database for the purpose of mailing newsletters and managing the subscription renewal process.