Worcester St Johns CC
Membership form
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Please print this form and complete the information
then send it with the relevent membership fees to
Dave Jennings
The Croft
Stonehall Common
Worcester WR5 3QG

Number Type Fee Total
  Senior Members @ £10 £
  Family Membership @ £12 £
  Junior Member @ £5 £
  Second Claim Member @ £8 £
    Grand Total £
  Membership details    
  Rejoining Member Y / N (please indicate)  
  Forenames    
  Surname    
  Male / Female (please indicate)    
  Address    
  Postcode    
  Telephone    
  E-mail    
  Date of Birth    
  Additional Names (Family Membership only)  
1      
2      
3      
4      

Your details will not be passed to any other source for any reason without your express permission in writing.
For more information Email postmaster@worcester-st-johns-cc.org.uk

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