Northern Veterans Athletics Club

I wish to apply for membership to NVAC for 2010. I enclose £10 (second claim) or £15 (first claim to include England Athletics levy) or £5 (Social Member). Cheque made payable to Northern Veterans AC and sent with a 9" x 6" SAE to:

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

..................................................................   Post Code :    ......................................     

Telephone No. :   .................................................

Date of birth : .....................................................        

First claim club :  ..........................................................................................................

E-mail address :  ..........................................................................................................

EA Registration No (second claim applicants only) :   ...................................................

(This number will be on your membership for your first claim club)

I agree to my details being kept on computer by NVAC and BMAF to allow information to be sent to my home address. Also to allow NVAC and BMAF to verify my eligibility to compete in veterans' events.

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