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Darlington and District OS - Application Form 2015-2016

Section A  Personal Details – Tick if you are willing for contact

       details to be shared with other members.


NAME(S) : Mr / Mrs. / Ms.  _____________________________


                     Mr / Mrs. / Ms.  _____________________________


Name(s) for badge : __________________    __________________


Email address (if you want to receive information in this way)


                   …………………………………….


Existing Members - If address and telephone number remain unchanged

then tick the box and move to Section B


Address       ____________________________________


                     ____________________________________


                     ____________________________________


Post Code    _____________   Telephone  _______  _________

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Section B  Statement


I / we wish to apply for Single(£6) / Joint(£10) membership of

Darlington and District Orchid Society and agree to abide by the rules of membership.


Signed ___________________________   Date ____________


Membership Fee Paid  £ _____


Please return forms to Chris Barker with Membership fee.


Membership Form