Membership Form 

The Scottish Cavalier King Charles Spaniel Club 

PATRON:       MRS  M  WORKMAN 



CHAIRMAN   MR R MORRISON

HON SEC:     MRS E SMITH                                                                                                                    

 9 ELM  GROVE, LARBERT,                                                                                                              

 STIRLINGSHIRE  FK5 3LP

 Tel. 01324 553331

 I/We  apply for election as a member(s) of the Scottish Cavalier King Charles Spaniel Club and agree to abide by the rules and regulations of the above Club, as in force at the time of my/our application or as may be subsequently amended at a General or Extraordinary General Meeting of the Club. I have read the enclosed Constitution and Guidelines.

 Signed ......................................................................................................

 Date...................... ...........................           :

 Proposed by: ........................................... (Print name) Signature

 Seconded by ............................................ (Print name) Signature

 (Proposer and seconder to be existing members of at least 2 years standing)

Enclosed is the membership fee (made payable to SCKCSC) of.

SINGLE MEMBERSHIP.        £8 + £2 ENROLMENT FEE

JOINT MEMBERSHIP           £10 + £2 ENROLMENT FEE

OVERSEAS MEMBERSHIP  £12 + £1 ENROLMENT FEE

JUNIOR MEMBERSHIP?       £3 + 50p ENROLMENT FEE (*Up to age 16)

 PLEASE COMPLETE THE FOLLOWING

MR (Surname) ......................................... Christian name

MRS ........................................................ ...........................................................

MASTER ................................................ ...........................................................

MISS ...................................................... ............................................................

 (IF JUNIOR PLEASE GIVE DATE OF BIRTH)

 ADDRESS????????????????????????????????????.

 POST CODE ?????????????????PH.NO ....................................................

E MAIL ???????????????????.             AFFIX???????????????   

 

 

  THE SCOTTISH CAVALIER KING CHARLES SPANIEL CLUB

 DATA PROTECTION ACT

 The Kennel Club now  requires the  number of  Members  on  our  List with the Annual returns. Our list is at present computerised and to comply with the data protection Act 1 ask that when you remit your Annual subscription whether paid by cheque/postal order or bankers order, permission is given to hold your membership details in this way.                                                                                                                                                                  

 I give the Scottish Cavalier King Charles Spaniel Club permission to hold my membership details on computer in order that the Scottish Cavalier King Charles Spaniel Club complies with the Data Protection Act and can furnish the Kennel Club with a correct Membership List. My membership details are as follows.

 MRS               SURNAME        ..............................FORENAME.....................................

 MASTER        SURNAME      ................................. FORENAME

 MISS               SURNAME                                      FORENAME

 TYPE OF MEMBERSHIP         SINGLE                 JOINT         JUNIOR

(PLEASE TICK WHICH)                       

 DATE OF BIRTH IF JUNIOR MEMBER .............................................

 AFFIX .....................................................

 ADDRESS ......... ........................................ ...........................................................................................

POSTCODE ......................................................................

 TELEPHONE (STD CODE) .....................NUMBER...........................

 SIGNED ............................. . .................................................... SIGNED

 SIGNED ................................................................................... SIGNED

 ALL MEMBERS TO SIGN WHETHER SINGLE, JOINT OR JUNIOR.

 Please return to the Secretary, Mrs E Smith  9 Elm Grove, Larbert Stirlingshire, FK5 3LP with your completed application form.