OXONIAN CYCLING CLUB

MEMBERSHIP APPLICATION FORM

I would like to apply for membership of the Oxonian C.C.

and if accepted I agree to abide by the Rules of the Club

NAME__________________________________________________________

 

9  1st CLAIM application            9   2nd CLAIM application

(If 2nd claim, my 1st claim Club is _________________________________)

ADDRESS_______________________________________________________

                    ________________________________________________________

POSTCODE__________________PHONE_____________________________

EMAIL __________________________________________________________

I am applying for the following membership(s)  (PLEASE £)

 

1ST OR 2ND CLAIM

!   Senior

£12

!   Veteran (over 40)

£12

!   Junior (16-18)

£4

!  Juvenile (under 16)

£2

 

ADDITIONAL FAMILY (one family member must be a Senior or a Vet)

!!!   Junior(s)

£2

!!!   Juvenile(s)

£1

 

STUDENT whose 1st claim Club is

!   Oxford University C.C.

£5

!   Oxford Brookes C.C.

£5

 

(Please detail their name(s)________________________________________

 

Please ask two 1st Claim members of Oxonian C.C. to propose and second your application form (if possible)

 

PROPOSED BY _________________SECONDED BY___________________

 

I enclose a cheque,

made payable to OXONIAN C.C. for £ ______  Date ___________________

 

 

Send this form to:

Liz Booker (Oxonian C.C. Membership Secretary)

Fairmead, School Lane, Tiddington, THAME, OX9 2NE

Tel : 01844 339451      email : Oxonians@tiscali.co.uk

 

 

If elected after 30 September your membership is effective to 31 December of the following year. You will be notified when elected by the Committee, who meet on the second Tuesday of each month.

 

(Date of acceptance by the Committee __________________________)