Somerset Lions Membership Form Season 2010-2011

New Membership Renewal

Please fill in your personal details
Name:

E-Mail:

Address 1:

Address 2:

Address 3:

Postcode:

Home Telephone:

Mobile Telephone:

Type of Membership Required

Adult £10.00
Youth (under16) £5.00

See below for address to send your subscription to.

Are you a Season Ticket Holder?

Yes
No

AVFC Client Reference No (if any)

Click send for your details to go to the Membership Secretary

Please post cheque made payable to "Somerset Lions" to

Bob Moore (Membership)
Somerset Lions
Flat 3 Lion House
Great Ostry
Shepton Mallet
Somerset
BA4 5TT