Leeds and District ASA

 

 

Individual Membership Application Form (2017)

Applicant Information

Applicant Details

Date:

Name:

     

Address:

     

 

     

 

     

Postcode:

     

Phone:

     

E-mail:

     

Date of Birth:

     

Type of Membership

 

Please choose the type of membership required (select one box only)

 

Adult Male/Female

54

Adult Male/Female (inc. Moor Monkton Pools)

64

Senior Citizen

26

Senior Citizen (inc. Moor Monkton Pools)

36

Disabled

26

Disabled (inc. Moor Monkton Pools)

36

Intermediate (16 to 18 Yrs)

26

Juvenile (Under 16)

16

Moor Monkton Pools Permit

10

 

Note: Please add 1 for postage.

 

Signature(s)

 

I apply to join Leeds and District Amalgamated Society of Anglers, and agree that I will abide by the rules and regulations as set down by the society.

 

 

Signed Signed

 

(Applicant) (Parent or Guardian if applicant under 18)

 

What to do next

 

Please send the completed form and a cheque for the correct amount (Please add 1 for postage). Please make cheque payable to Leeds and District Amalgamated Society of Anglers and send to:

Leeds and District Amalgamated Society of Anglers

Membership Office

The Anglers Club

75 Stoney Rock Lane
Beckett Street

Leeds LS9 7TB