APPLICATION FOR MEMBERSHIP OF THE PAISLEY & DISTRICT BS

The subscription rates for 2009 All Memberships:   £10.00

FULL NAME:- .............................................................................................................................

ADDRESS:-...............................................................................................................................

.................................................................................................................................................

...................................................................................................................................................

POSTCODE :-  ...................................................TELEPHONE No:-.................................................

Have you ever been convicted of any offence against any  bird(s) or animal(s)   ?       YES/NO

Have you ever been convicted of theft of any bird or animal                              ?       YES/NO

Have you ever been refused membership or had your membership rescinded by any livestock or bird society                                                      ?                     YES/NO

DECLARATION

I confirm that I   (print name(s):-...........................................................................

Will accept and abide by the official rules of the society.In the event that it is proved that i have made any false statment, I accept that my application may be rejected by a decision of the society.

SIGNED:- .....................................................      DATED:-..................................................

Please return to the secretary

HOME PAGE

copyright paisley & district budgerigar society and j.smith