|
A (*) denotes compulsory to complete this question |
|
| I wish to APPLY FOR / RENEW my membership of the South of England Athletics Officials' Association (£10). (*) |
Invalid Input |
|
| Mr,Mrs,Miss,Ms,Dr,Other (*) |
Invalid Input |
|
| First Name (*) |
Please type your first name. |
|
| Surname (*) |
Please enter your surname |
|
Address
For present members please fill in name and post code only unless other details have changed.
|
Invalid Input |
|
| Postcode (*) |
Please enter your postcode, even if you are renewing. |
|
E-mail
If you would like to receive your Newsletter by email please include your e-mail address. |
Invalid email address. |
|
| Tel (home) |
Invalid Input |
|
| Tel (mobile) |
Invalid Input |
|
| Tel (work) |
Invalid Input |
|
| Licence number (*) |
Invalid Input |
|
| County Affiliation |
Invalid Input |
|
| Please enter your discipline/s and level at each |
Invalid Input |
|
| 2012 National (UKA) Rulebook will be sent to all new members at no cost |
Invalid Input |
|
| 2012 ESAA Handbook is available free to members when available - usually February/March (*) |
Invalid Input |
|
| 2012 lAAF Handbook English edition unless you specifically request the French or Spanish (£5) (*) |
Invalid Input |
|
| Would you like to receive our newsletter by email? |
Invalid Input |
|
|
Subscriptions are £10 a year or £15 with IAAF handbook
to: Ian Murdoch, Membership Secretary
12 Corfe Walk, Winklebury, Basingstoke, Hants RG23 8ED
membershipsec@SEAOA.co.uk |
|
| I will pay by: (choose one) |
Invalid Input |
|
| Write any additional notes here (membership queries only - other comments to webmaster@SEAOA.co.uk) |
Invalid Input |
|
|
|
|
|
In Accordance with the Data Protection Act 1988, SEAOA will collect, use, protect and retain the
information on this form for the purpose of membership and obligations in connection with the
Association. It will not be passed to any other companies without permission from its members. |
|
