Stevenage Cycling Club

 Membership Application & Renewal Form 2012

www.stevenagecc.org.uk

 

2012 Membership Rates

 

Adult                      £15

Junior (16-18)      £5

Schoolboy/girl    Free

 

 

First Name…………………………………………………………………………….

 

 

Last Name…………………………………………………………………………….

 

 

Address………………………………………………………………………………..

 

 

…………………………………………………………………………………………..

 

 

Phone Number (including STD Code)……………………………………………

 

 

Mobile Number……………………………………………………………………….

 

 

Email Address………………………………………………………………………..

 

 

 

Please make cheques out to “Stevenage Cycling Club” and post with completed application form to;

 

 

Norma Nickolay

105 Ely Close

Stevenage

SG1 4NR