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Subscriptions

HRUFC SUBSCRIPTIONS 2007/08

Name ................................................................................... Wife/Partner Name ................................................................

Address ....................................................................................................................................................................................

....................................................................................................................................... Postcode ..........................................

Email address ........................................................................................................... DOB for under 21 ............................

Home telephone ................................................................ Mobile telephone ...................................................................

Membership Categories

Ordinary Club Member	£70.00	...................................................
Road Running Member	£70.00	...................................................
Rugby Playing Member	£70.00	...................................................
Squash Playing Member	£70.00	...................................................
Under 21 (1^st Sept)/Student of above categories	£35.00	...................................................
Wife/Partner of a full paying member	£25.00	...................................................
Borough Club	£170.00	...................................................
Borough Club/Patron	£200.00	...................................................
Patron	£150.00	...................................................
Sub total		...................................................
Payments received before 1st September 2007 deduct £5.00		...................................................
Total		...................................................

I enclose a cheque payable to Huddersfield RUFC for £ ......................... or
Debit my VISA / Mastercard by the amount above

Card Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Issue Date _ _/ _ _ Expiry Date _ _/ _ _

Name on Card ........................................................
Signature .................................................................... Date ..................................

For Office Use

Date Received	0	Amount	£
Membership Number	0	0	Cheque/Cash

Huddersfield Rugby Union Lockwood Park Huddersfield HD4 6EN T. 01484 469801 F. 01484 469880 E. info@huddersfieldrugby.com