SERCCC  MEMBERSHIP FORM

 

 

Name:                _________________________________________

 

Address                _________________________________________

 

Home Phone:        _________________________________________

 

Mobile:                _________________________________________

 

Email:                _________________________________________

 

 

Application for Full Membership of SERCCC

 

 

I _____________________________________________   

 

Desire to become a member of South Eastern Radio Controlled Car Club. In the event of my admission as a member, I agree to be bound by the rules of the association for time being in force.

 

 

Signed:_____________________________________                 

 

Date:________/________/__________

 

Senior Member

 

Annual Membership:                                            $30.00

 

Junior Member

 

Annual Membership                                            $15.00

 

Total:                                                $      .00

 

Date Approved: _______________    Membership No: __________________

 

 

Approved by Senior Committee Member_____________________________