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CYM
Sports Club
APPLICATION FOR MEMBERSHIP please mail to: Name:------------------------------------------------------------------------------ Address:--------------------------------------------------------------------------- ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- E-Mail Address:----------------------------------------------------------------- Phone : (Home) --------------------------------- : (Office)-------------------------------- : (Mobile)------------------------------- Date of Birth : ---/---/--- (if under 21)
Signed:--------------------------------------- Date :-------------------- I also apply for membership of the ------------------------------
Section Society Fee: --------------- Section Fee: ------------------ PROPOSERS CERTIFICATE (New Members)
Proposer:----------------------------------------- Date:---------------- Seconder:----------------------------------------- Date:---------------- Applicants Credit Card Details Full Name on Credit
Card:
Expiry Date:
. Card Type Type:
(Visa, Mastercard, AM Express etc.)
Credit Card No.: . Amount:
. Signature of Credit
Card Holder:
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