Application for Membership

Full Name
Address
Home Telephone Number
Daytime Telephone Number
Date of Birth

Please list all other clubs of which you are a member
Have you ever been disciplined by an angling club?	yes / no
If yes please give details

Have you a particular interest in any species of fish?	yes / no
If yes, which species
Please list details of any society waters you have previously fished
Do you know any other senior members?	yes / no name
How did you hear about the society
Are you prepared to attend a meeting for your application to be considered?	yes / no
If accepted will you?
(a) Agree to regularly attend work parties	yes / no
(b) Read and obey the rules of the society	yes / no
(c) Attend social and fundraising events	yes / no
(d) Are you likely to attend any club, open or pike matches?	yes / no
(e) Read and note the newsletter and its contents?	yes / no
(f) Fish regularly at any one water?	yes / no which water?
(g) After two year membership will you apply for a carp night ticket?	yes /no

I propose the above named for members of the society

Full Name
Address
Home Telephone Number
Date of joining

I declare that I wish to apply for membership of the above society and the details I have given are correct. If I am later proven to have knowingly made a false statement then I accept that this will result in my expulsion from the society. I further declare that I am not involved with any group or organisation whose activities may be detrimental to the sport of angling.

Signed...................................................... Date............................

Please print and complete this form and forward together with an SAE to:

Membership Secretary
5 Russet Close
Tongham
Farnham
Surrey
GU10 1BN