COLNE SMACK PRESERVATION SOCIETY

Name: ...................................................................................................................

Address: ................................................................................................................

Postcode: ....................................................... Date of Birth: .............................

Tels: Home/*Work/*Mobile/*Fax .......................................................................

*Email Address: ..............................................................................Occupation: ........................

Do you own a smack?......... Wish to / crewed on a smack?.............. Have history of a smack?.....................

*Details of Smack; Name: ...................................Number:.................. Builder:.......................................... Date:..................

I wish to apply for membership of the Colne Smack Preservation Society. If elected, I will abide by the Rules.

Signed: .......................................................Date:.................................

Proposer: ........................................................Signed ............................................Date:........................

Seconder: ........................................................Signed ............................................Date:...........................

Both Proposer and Seconder must be Members of the Society. Leave blank if none known to you.

Your application will be considered at the next monthly Committee meeting.

The Standing Order will not be submitted to your bank until you have been elected.

Return this form to Robin Page, Hon. Sec, 49 Colne Road, Brightlingsea, Essex.

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STANDING ORDER

To: (the name of your bank).................................................................... Sort Code:............................

Bank Address: ..........................................................................................................................................

Name of your Account: .............................................................. .Account Number:................................

Please credit account of Colne Smack Preservation Society ( Barclays Bank PLC, Brightlingsea, Essex:

A/c No. 00100498 Sort Code: 20 21 73 ) the sum of £ 10 (Ten Pounds) immediately and thereafter on

1st. November annually, until this order is cancelled in writing. This supersedes any previous order.

Please notify with payment; Subs from ............................................................. (your name)

Signature ....................................................................... Date: ..................................