Clowns International
Membership Application Form
Clown Name ...............................................................................
Name ...........................................................................................
Address .................................................................................................................................................
.............................................................................................................................................................
Post Code .................Telephone Number/s...............................................
Date of Birth for Junior and Senior Members _ _/_ _/_ _
Signature ...............................................................
*Proposed by (CI Member) ............................................... Membership No. .........
*Seconded by (CI Member) .............................................. Membership No. ..........
*(Applications will be considered without a Proposer and Seconder but applicants will normally be asked to join as a "Provisional Member" for the first year of membership, and subsequently may re-apply for Full Membership. Does not apply to overseas Clowns).
Are you a NEW/BEGINNER Clown? ......................... How long have you been Clowning? ........................
What type of Clown are you? August ...... Whiteface ..... Droll ...... Hobo/Tramp ........
List any skills...........................................................................................................................................
...............................................................................................................................................................
PLEASE TICK APPROPRIATE FEE BELOW:
Membership Fee in UK: Sterling Thirty Pounds (30.00) ....
Provisional Member Sterling Thirty Pounds (30.00) ....
Membership Fee in UK for Senior clowns (over 65 years) Sterling Fifteen Pounds (15.00) ....
Membership Fee for Junior clowns (under 16 years) Sterling Eight Pounds (8.00) ....
Membership Fee for Friends of Clowns Sterling Fifteen Pounds (15.00) ....
Membership Fee outside UK Sterling Thirty Pounds (30.00) ....
(Please send subs in pounds sterling or bankers draft or credit card details below)
(European clowns can also pay by EuroCheque) One Pound Sterling(1.00) will be added to Credit Card transactions
Please note regretfully Senior and Junior Membership is not available to Overseas Members or Friends.
| I wish to pay
by Credit Card. Tick Type of Card (please ): Visa ........ MasterCard
........
Please add One Pound Sterling (1.00) to your subscription if paying by Credit Card Card Number: |
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Expiry Date: ........................................... Signature: .................................................. Amount (Pounds Sterling)........................ Name on Card: .........................................(Please Print) |
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| Please
submit this application with a photograph of yourself in full make-up,
together with appropriate cheque or postal order made payable to CLOWNS
INTERNATIONAL, or complete your credit card details above.
Send a self addressed envelope with your subscription to:- BLUE "CLOWN BLUEY" BRATTLE, The Secretary, Clowns International, 30 Sandpiper Close, Marchwood, Southampton, Hants, England, S040 4XN |
CHECK LIST: Have you enclosed: Subscription. Photograph. Addressed Envelope.
Because you are a member of Clowns International and abide by the rules of Clowns International, those facts are taken as constituting deemed consent to your membership details being held by Clowns International for the purposes of the Data Protection Act 1984
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