THE PALLADIUM CLUB BIDEFORD
Lower Gunstone, BIDEFORD, North Devon, EX39 2DE
TEL:01237 478860 Membership Application Form | NAME OF APPLICANT | __________________________ | | ADDRESS | __________________________ | | ADDRESS | __________________________ | | TEL NO | __________________________ | | NAME OF PROPOSER(member) | __________________________ | | Membership No | __________________________ | | NAME OF SECONDER(member) | __________________________ | | Membership No | __________________________ | | Applicant's Date of Birth (Proof required if under 25 years of age) | __________________________ | | | | | If accepted as a member I agree to abide by the rules set down by the club | __________________________ | | APPLICANT'S SIGNATURE | __________________________ |
COMMITTEE USE ONLY | Date Application Received: | | | Set Before Committee: | | | Application Accepted (Yes/No) | | | Membership No. Issued: | |
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