MEMBERSHIP APPLICATION
(please print off a copy of the following form & write
clearly!)
I
wish to apply for membership of CVAG and my personal details are as follows:
Name
... Title: Mr Mrs Ms
Other
........
Address
Postcode
.. Telephone
.....
.
E-mail
If
you do not wish for your e-mail address to be used by CVAG or do not have an
e-mail facility, please arrange to speak to a CVAG Committee Member to arrange
alternatives.
I understand that this information has
been collected for use by CVAG primarily for registration and direct
communication purposes only. I understand that information collected may be
kept on a computer. The information will be held for access only by elected
CVAG Committee Members and used for no purpose other than those identified in
support of the specific objectives of CVAG. The information will be deleted
immediately on request.
I enclose £5* for one year full membership
£20* for 5 years membership
£
A donation towards the
associations running expenses
Signature
.. In capitals
Date
.............
************************************************************************
*
£5 is the Joining fee including Membership fee for the first year or part year
[till the AGM 2009]. £20 is the Joining fee including Membership fee for the
first year or part year plus a further 4 full years of annual Membership fees.
Membership provides: for direct distribution of the
regular CVAG newsletters and other information; for communication direct to
your elected Committee of your valued views on matters important to you and the
village; for a vote on any proposals and the election of the Committee at the
next CVAG AGM.
Please return completed form with the appropriate fee to
the Membership Secretary:
Suzanne Hines. 4, Ardwell
Close. Tel 774247. Email address: suzanne@cvag.org.uk
Please do not forget to sign and date your application
Official use only: Membership number issued Version 1.3
Ref 1................................... . Ref 2...........................................Ref 3...................................