Contact Membership Form

Branch: SOUTH WALES

Name:………………………………………………………………
Address: ………………………………………………………….
……………………………………………………………………….
Post code:…………………………………………………………
Phone/Mobile Number:………………………………………

Email:…………………………………………………………

Date of Birth :……………………………………………………

EFC Customer Ref No:………………………………….

Signature:………………………….Dated:……………………
Membership Fees are for the season are .
Adults £8  Seniors £4  Juniors £4 .
Please return to Mike Kempson 13,Vivian Road , Newport np190er .

Cheque or Bank Transfer Sort Code 07 01 16 Account Number 34443649.