Please Give These Details for Each Member and Continue Overleaf If Necessary

Application Form

We welcomemembership applications: our subscriptions encourage couples and families to joinand there’s also a discount of £5 per member * for any second and subsequent younger members at the same address.

Category / Description / Year
Adult / A / Any adult aged over 23 years / £165
Couple / C / Two adults at the same address / £300
Family / F / Two adults plus under 23s (born after 1.9.94) at same address / £360
Student / St* / Born after 1 September 1994and absent during term time / £33
Young / Y* / Born between 1 September 1994 and 31 August 2001 / £72
Junior / J* / Born between 1 September 2001 and 31 August 2010 / £72
Mini / M* / Born after 1 September 2010 / £22
Social / Soc / Non-playing adult / £17

Please give these details for each member and continue overleaf if necessary:

Name
Male / female
Date of birth (if under 23)
Membership category
Subscription
Address and postcode
Email
(please type or write clearly)
Phone (landline)
Phone (mobile)
A clubhouse key(charge £10 - add to subscription) may be requested by members aged over 18for access to operate the floodlights up to 9pm on dark evenings. Would you like one? / Yes / No
(delete one)
Are you happy for us to give your contact details to the Head Coach? / Yes / No
(delete one)
Weoccasionally circulate emails and phone numbers of members aged over 18who’d like to be included to other members aged over 18. Are you happy for us to circulate your details? / Yes / No
(delete one)
Anything else we should know?
(eg medical conditions for under18s)
Total payment: £……… / Will you pay by bank transfer or cheque? Transfer / Cheque(delete one)

Transfer: our bank details are Little Chalfont Tennis Club, HSBC Amersham,Sort Code: 40-08-41, Account 91130315. Put the member's name as a reference and email this completed applicationformtoour Membership and Treasurer

Cheque:payable to Little Chalfont Tennis Club to be sentwith the completed applicationfrom to our Membership Secretary: Mike Fenton, Roughwood Cottage, Roughwood Lane, Chalfont St Giles, Bucks HP8 4AA;or give them to our Head Coach, Colin Williams who’s very often at the Club.

Thank you!

Little Chalfont Tennis Club

Application form continued

Details of additional family members where the information is different from that overleaf:

Name
Male / female
Date of birth (if under 23)
Membership category
Subscription
Email
(please type or write clearly)
Phone (mobile)
Name
Male / female
Date of birth (if under 23)
Membership category
Subscription
Email
(please type or write clearly)
Phone (mobile)