Pembrokeshire Yacht Club
Application For Membership

Please reply to:
Membership Secretary, Wharepuna, Clay Lane,
Milford Haven SA73 3RX
Tel; 01646 692010 E-Mail: gordonp.thompson@virgin.net

1. Name (Block Capitals)...................................................................................................................................

2. Address.........................................................................................................................................................

3. Post Code...............................................

4. Telephone No..........................Mobile........................... E-Mail Address.......................................................

5. Do you own a boat?................ If yes, please state type..................................................................................

6. Will you require boat parking? YES / NO - There is NO guarantee of an immediate parking space.
Will you require a mooring? YES / NO

7. Please give names of any sporting or social club of which you are a member...................................................

I submit my application for membership of The Pembrokeshire Yacht Club. If elected I agree
to abide by the Rules and Constitution of The Club, and to pay my subscription by standing
order through a bank.

Signed................................................................................................. Date....................................................

Sponsors (Please note - both must be voting members of the Club)

Proposed by:

Name.......................................................Membership Number............Signature..............................

Seconded by:

Name........................................................Membership Number...........Signature...............................

Fees: Subscription £40:00 per annum.

Please note:- Please complete this application form together with the attached bankers
order and return both pages to the Club.

Thank you.

Pembrokeshire Yacht Club
Gellyswick Bay, Milford Haven,
Pembrokeshire. SA73 3RS
Telephone: 01646 692799

Standing Order

To Bank / Building Society ( Block Capitals Please ):-

.........................................................................................................................................................

Bank Address Complete including Post Code ( Block Capitals Please ) :-

………………………..........................................................................................................................

..............................................................................................................................................................

Bank Post Code:- ……………………………….

Please make payments and Debit my / our Account:-

Number:- .................................................................. Sort Code:- ……../………../……...

in accordance with the following details to :-
Lloyds TSB Ltd. Hamilton Terrace, Milford Haven, Pembrokeshire. SA73 3AP
For the Account of the Pembrokeshire Yacht Club Account No:- 01073670
Sort Code:- 30-93-98

As follows:-
Immediately:- £40.00 ( Forty Pounds )
And then:-
Pay the sum of £45.00 on 1st October 2011
and then annually until further notice.

Signature ( s ) ....................................................................Date……………………

Print Name ................................................................................................................

Address...............................................................................................................................................

.......................................................................................... Post Code ................................................

To Bank / Building Society Please Quote this reference on all payments:-