Please print this page and send it by post with full payment to:-

Cheques etc can be sent to the treasurer :-

Don Kenwood,
154, Kenn Road,
Clevedon,
North Somerset,
BS21 6JY

Tel. No. 01275 343949

Membership Application (please use block capitals)

Applicant : Name ........................................................................................

Address …………………………………………………………

…………………………………………………………

…………………………………………………………

Post code .........................................................................

Country .........................................................................

Telephone number ...............................................................................

E mail address ...............................................................................

I wish to apply for membership of the British livebearer Association with affect from May 1st, 2007.

I enclose membership fee UK £12.00 overseas £16.00 Sterling (delete as appropriate)

All cheques should be made payable to British Livebearer Association.

Signed................................................................................. Date................................................