Leatherhead Angling Society

APPLICATION FORM FOR PAYMENT BY BANK TRANSFER ONLY

NAME:

ADDRESS:

POST CODE:

PHONE NUMBER:

EMAIL : (REQUIRED)

Choose the correct level of membership carefully.

RENEWAL SENIOR (22 - 64) £70
NEW SENIOR (22-64) £90 (first year)
RENEWAL SENIOR CITIZEN (65+) £40
NEW SENIOR CITIZEN (65+) £50 (first year)
RENEWAL YOUNG SENIOR (18-21) £40
NEW YOUNG SENIOR (18-21) £50 (first year)
RENEWAL DISABLED £40
NEW DISABLED £50 (first year)
RENEWAL *FAMILY 4 (2 ADULTS+2 JUNIORS) £120 (Under six go free)
NEW * FAMILY 4 (2 ADULTS+2 JUNIORS) £145 (first year) (Under six go free)
RENEWAL *FAMILY 2 (1 SENIOR+1 JUNIORS) £77 (Under six go free)
NEW *FAMILY 2 (1 SENIOR+1 JUNIORS) £97 (first year) (Under six go free)
JUNIOR UNDER 12 as at 1st April £17 (no joining fee)
JUNIOR 12 - 17 as at 1st April £27 (no joining fee)

* ENTER ALL FAMILY NAMES AND AGES WITH DOB OF JUNIORS

JUNIOR MEMBERSHIP DATE OF BIRTH:

LDAS METAL PIN BADGE £5 ea
DONATION TO FISHERY FUND £3
DONATION TO FISHERY FUND £5
DONATION TO FISHERY FUND £10
DONATION TO FISHERY FUND £20
DONATION TO FISHERY FUND £30

ADD NOTE:

Bank transfer (BACS) to: HSBC A/C 01433636 SORT CODE: 40-38-10 Add your name as reference

TOTAL AMOUNT PAID TO BANK:

Allow 7 working days for competition of your application. Thank you for joining the LDAS.

User Agreement

By completing this form you agree to the LDAS club Rules (2020) which can be found on the website ww.leatherheadangling.co.uk

Check the box below to agree to receive information from LDAS regarding Club Events and Matches and occasional Newsletters.

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Contact membership@leatherheadangling for any issues with this form.