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Season 1 April 2010 to 31 March 2011
Tick boxes below to
confirm your
requirements - one
form per person please | Adult
Members
(17 to 64 yrs inc) | Juniors (Under
12 yrs as at
1 April 2009)
No charge | Senior Citizens
(65 yrs and
over as
at 1 April 2009 | Disabled
Persons
(registered) [Note 2] | Annual Subscription
[Note 1] | £30
| £10
(12-16 years inclusive) | £20
| £20
| | Joining Fee (once only) | £5 | £0 | £5 | £5 | Companion Membership
(non fishing)
Enter name here
----------------------------- | £ 5 | £5
(Juniors must be
accompanied by an Adult at all times) | £5 | £5 | CALPAC Membership
(20+ extra waters)
(Adult)
(Intermediate) [Note 3]
(Junior) |
£38
£32 |
£26 |
£26 |
£26 | Bough Beech
Reservoir
(optional - no concessions) | £15
| £15
| £15
| £15
| Donations to
Funds (optional) | £ | £ | £ | £ | | Total | £ | £ | £ | £ |
Please tick your requirements and forward a total for the whole amount (cheques/postal orders being made payable to Warlingham & District Anglers’ Society) to Mr. Ray Hambling, 80 Orchard Avenue, Shirley, Croydon, Surrey. CR0 7NB. Tel. No. 020 8676 1693 (Only one renewal/application per form). No personal callers please.
Please submit your application with a (C5 - 9" x 6.5") correctly stamped and addressed envelope
NAME IN FULL………………………………………………………………………………
ADDRESS……………………………………………………………………………………..
…………………………………………………………………………………………………..
TELPEPHONE No:………………………………. DATE OF BIRTH: ………………….
ANY PROFESSIONAL SKILLS YOU CAN OFFER THE SOCIETY?
…………………………………………………………………………………………………...
| Note 1 | Includes Basingstoke Canal ticket - over 26 miles of water | | Note 2 | You must provide proof of entitlement by producing any of the following: Current allowance/Pension book/Giro Payment Slip showing the proposed licensee is in receipt of either: - Severe Disablement Allowance, Invalidity Benefit, Long-term or Short-term higher rate Incapacity Benefit, War Pension including Unemployable Supplement or a letter from the War Pensions Directorate, Blackpool confirming eligibility. | | Note 3 | CALPAC have an Intermediate level of membership for 16 and 17 year olds. |
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