TYNE ROAD CLUB
Mr M Glass, Tyne Road Club General Secretary, The Old Blacksmiths Cottage, Mitford, Morpeth, NE61 3PR
Surname ______________________________________
First Name ______________________________________
Date of Birth ______________________________________
Address ______________________________________
______________________________________
______________________________________
______________________________________
Postcode ______________________________________
Telephone No. ______________________________________
Whether applying for first claim, second claim or associate membership (state which):-
______________________________________
If applying for second claim membership, name of first claim club:-
______________________________________
Whether already a member of the CTC, BCF or other and if so which:- ______________________________________
DECLARATION
I apply for membership of the Tyne Road Club, and agree to abide by the Club Rules. I enclose a cheque payable to the TYNE ROAD CLUB for the first years membership fee of £5.00.
Signed ______________________________________
Committee
Seconded by ___________________ Accepted by _____________________
club