Membership Application Form
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Please print this form, enter your details below
and submit the completed application, with payment to The Admissions
Committee at the address above.
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| Full Name |
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| Known As |
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eg. Bill, Jake, Terry |
| Address |
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| Date of Birth |
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Marital status |
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| Occupation |
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| Corporation Name* |
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| Daytime Tel |
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| Home Tel |
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| Mobile Tel |
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| EMail Address |
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| Handicap* |
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Member No.* |
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| Membership type |
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| Membership Fee |
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* if any
I hereby apply to be elected as a member of
the Bedwell Park Club. I have read and will abide by the
rules of
the club.
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| Signature |
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| Date |
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