Agility Club Membership Form

Membership Form

Please complete on screen before printing.

Your Name:

Name of member recommending you:
(for 2 months free additional membership)

Your Address:
Please include Post Code

Telephone:

email:

How did you hear about us?

Single Membership	£23
Family Membership	£28
Overseas Membership (outside UK)	£36
Please Select:	New Member	Renewal

Family Membership

Please list additional members:
(All must reside at same address)

Please send your form and cheque to:
(Sterling only and made payable to the Agility Club)

Virginia Harry, 6 Fane Way, Maidenhead, Berks, SL6 2TL

Membership acceptance is at the discretion of the committee