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WEST PENNINE RUNNERS

  

Membership Application Form

 

Full Name:                    ……………………………………………………… 

Date of Birth:                …………………………… 

Address:                       …………………………………………………………

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Telephone Number ( Including STD Code )      ……………………………

e-mail address              ……………………………………………………………

 

Are you currently a member of another club?     Yes / No

 

If Yes, please state the name of the club            ………………………………………

 

If Yes, which is your First Choice Club ………………………………………

 

The cost of Membership is:       £6.00p

 

Signature:         ……………………………..

 

Please fill this form in and return it to The Club Secretary;

 

Jan Holding      1 Stanhill Street, Darwen, Lancs BB3 2NB       Tel: 01254 774540

 

The other Club Officers are;

 

Chairman               Barry Nicholson.            64 Cloister Drive, Darwen, Lancs BB3 3JX

                                Tel: 01254 703134 e-mail      nicholsb@skynow.net

 

Treasurer               Peter Demaine                 3 Pleasant View, Blackburn, Lancs BB3 3HF

                                Tel: 01254 681551 e-mail      peter.demaine@btinternet.com

 

Men’s Captain      Neil Holding                    1 Sandhill Street, Darwen, Lancs BB3 2NB

                                Tel: 01254 774540

 

Ladies Captain      Sheila Fogg                           38 Alders Green Rd, Hindley, Wigan, WN2 4CA

                                Tel: 01942 523340