WARWICKSHIRE FLY FISHERS Membership Application Form.

I wish to be considered for:

 Full / Catch & Release / Limited visits / Junior / River membership.  (Please circle your choice.)

Name …………………………………………………………………………………

Address ………………………………………………………………………………

Town ……………………………………..  Post Code………………………………

Telephone number including code ……………………………………………

Email address ……………………………………………………………………

Date of birth ……./………./……….       Occupation ……………………………..

I am a member of the following angling Clubs/Associations:- ………………………

…………………………………………………………………………………………..

Have you ever been banned from or refused membership of any angling Club or Association?

Please tick          YES …….          NO …….    If YES please give details overleaf

How many years fly fishing experience have you? ............................................years.

Are you interested in competition fly fishing?          Please tick          YES …….    NO …….

If “YES” please state experience …………………………………………………….........

Where did you hear about Warwickshire Fly Fishers ? ……………….………………………

(If you were introduced by a member please give their name, they may be able to claim a discount on their subscription.)

If accepted for membership I agree to abide by the Rules of the Club.

I understand my details will be kept on a Computer Data Base for the sole use of Warwickshire Fly Fishers.

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

For Junior applicants (Under sixteen years) countersignature of parent or guardian.

Signed ……………………………………………        Date ………………………

Please Return This Form Complete with your cheque and a passport size photograph to:  Chris Skuse,  87 Northumberland Road, Leamington Spa,  CV32 6HQ.

Or any Club Officer or Committee Member

CHEQUES SHOULD BE MADE PAYABLE TO WARWICKSHIRE FLY FISHERS

For Club use only

Accepted   YES/NO       Membership Number………  Membership List  ………     Email Group…………

M’ship Book  ……       Photograph  .......... Maps ……       Car Sticker .......    Bounty recorded…………….

Subscription Paid  £…… …Deposit (C & R)   £............   Discount £………..TOTAL £………..