BRITISH CONGER CLUB

MEMBERSHIP APPLICATION FORM FOR ALL APPLICANTS
Fees applicable until 31st December 2017
Please check the form where appropriate and fill in any details that are required
Full Membership Requirements Congers Sizes - Shore(25lb)-Reef/Open Ground (30lb)-Wreck(40lb)

Full Membership 20 annually   FULL MEMBERSHIP   [  ]     FULL ASSOCIATE [  ]
Life Membership 200 
*see requirements from 1st Jan 2013
LIFE FULL [  ] LIFE ASSOCIATE [  ]
Life Membership(60+ years of age) 100 LIFE 60+  [  ] 
Senior Membership(60+ years of age)10 annually SENIOR 60+ FULL [  ] SENIOR 60+ ASSOCIATE [  ]
Affiliated Club 30 annually   AFFILIATED CLUB       [  ]
S.T.R.A.P.S Membership 2 Annually STRAPS       [  ]
INDIVIDUAL DETAILS AMOUNT OF FEE ENCLOSED [                                           ]
FORENAME SURNAME
ADDRESS  
  email:
CITY COUNTRY
POST CODE or ZIP Telephone No:
QUALIFYING DETAILS IF APPROPRIATE DATE CAPTURED 
Place of Capture BOAT      [  ] SHORE   [  ]
If weight assessed by Boat Skipper        [  ]       SKIPPERS NAME 
BOAT NAME                                                                                 PORT
WITNESS 1.            
WITNESS 2.
APPLICANTS SIGNATURE                                                                         DATE
AFFILIATED CLUB DETAILS
CLUB NAME
CLUB ADDRESS
NAME OF PERSON MAKING APPLICATION
SIGNATURE OF PERSON MAKING APPLICATION
EMAIL ADDRESS
Please send this document with your cheque MADE PAYABLE to: 
THE BRITISH CONGER CLUB
PAUL SWEETMAN, 61 Foxes Meadow, Cotterridge, Birmingham, B30 1BQ, UK    
email: registrar@britishcongerclub.org.uk