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 £35:00 per annum.

Please note:- Please complete this application form together with the attached bankers
order and returnboth 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:- £35.00 ( Thirty Five Pounds )
And then:-
Pay the sum of £40.00 on 1st October 2009 and 1st October 2010
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:-