HUCCLECOTE COMMUNITY ASSOCIATION

Application for Membership (Please give full names of everyone covered by this application)

TITLE / SURNAME / FIRST NAME(S) / OCCUPATION
ADULT 1 / Mr/Mrs/Ms
ADULT 2 / Mr/Mrs/Ms
CHILD 1 / B / G / Age:
CHILD 2 / B / G / Age:
CHILD 3 / B / G / Age:
CHILD 4* / B / G / Age:
E-MAIL ADDRESS:
ADDRESS:
POSTCODE: / TELEPHONE:

* LIST ANY FURTHER

CHILDREN HERE: …………………………………………………………………………………………………….

For memberships taken out between Dec 1st 2016 & Apr 30th 2017, pay FULL YEAR PRICE, and then renew by Jan 31st 2018.

For memberships taken out between May 1st & Aug 31st 2017, pay HALF YEAR PRICE, and then renew at full year price by Jan 31st 2018.

For memberships taken out between Sept 1st & Dec 31st 2017, no need to renew until January 2019.

CATEGORY
NEW MEMBERSHIP / Full year / Half year / PAYMENT ENCLOSED
INDIVIDUAL ADULT / 7.00 / 4.00 / £
FAMILY (includes 2 adults + children up to age 18) / 14.00 / 8.00 / £
ONE-PARENT FAMILY (includes children up to age 18) / 7.00 / 4.00 / £
SENIOR CITIZEN / 5.00 / 3.00 / £
CONCESSION (those on benefits) / 5.00 / 3.00 / £
CONCESSIONARY FAMILY (on benefits + children) / 10.00 / 6.00 / £

If renewing, please ensure you collect a 2017 membership validity label for your card.

I/We agree to abide by the Constitution and Conditions of Membership of Hucclecote Community Association..

Signed …………………………………………………………………….. Date …………………………..

Cheques to be made payable to: “HCA”

WEEKEND EVENING

HALL HIRE NOW FREE

(see below, conditions apply)

For your …………….

Birthdays,

Anniversaries,

and other Family Parties

Weekend Bookings

availablein the

Community Centre Hall

Bar facilities, Use of Kitchen, Disco,

Subdued Lighting, Microphones, etc.

Hire of the Hall & Kitchen for adult functions on Fridaysafter 7 pmand on Saturdays or Sundaysafter 6 pmis now FREEto membersas long as there is significant use

of the bar (otherwise £14.50 per hour)

Disco + DJ £130

(all subject to availability, terms & conditions)

Ask for details at the HCA Office

or ring 01452 616289 or e-mail

HUCCLECOTE COMMUNITY ASSOCIATION

(Registered Charity No. 301550)

Application Form

for New Membership

Please complete all sections of the form insideand hand it in, with the correct payment, to the Office or the Bar.

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Membership cards need to be collected from the Office or the Bar; they should be available 7 – 10 days following application.

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All memberships expire on Dec 31st, and need to be renewed by Jan 31st (except that memberships taken out between Sept 1st and Dec 31st run until Dec 31st of the following year).

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Membership cards are subject to a replacement fee of £1.00 if lost or damaged.

PLEASE NOTE:

The Association’s records are held on computer; they are held for the purposes of membership administration only, and will not be passed to any other persons or agencies for any purposes whatsoever. If you have any objections to your membership data being kept in this way, please contact the Office as soon as possible.