England Netball
Taster Rate New Club Application Form 2015/16
League & County Details
LEAGUE NAME:
COUNTY:
…………………………………………………..
…………………………………………………
Contact Details
CLUB NAME:
CLUB
MS / MRS / MISS / MR
(full name please)
SECRETARY*:
FULL
ADDRESS:
POSTCODE:
TELEPHONE
H/W/M
EMAIL:
NO’S:
H/W/M
Does the Secretary have England Netball membership?
YES / NO*
NETBALL
ID:
Please tick which Membership Category is applicable:
Netball Club
Young Persons Group (14 & Under)
Young Persons Group (18 & Under)
Young Persons Group (11 & under)
*Please note that the nominated Secretary must be aged 19 years at 1 st September 2015
Payment Details
I enclose a cheque payment of £_________ to affiliate ______ individuals (as detailed on the Participants Form)
for the England Netball Taster Rate Membership. I confirm that, to the best of my knowledge, these individuals
have not been members of EN within the past three years.
Membership Fee: Taster Rate - Netball Club / Young Persons Group*
£
+ Region & County fee (if applicable, contact Membership Dept.)
£
Total Payment Enclosed
£
If you wish to make an online payment, once the Participants have been entered onto MyNet an invoice will be in
your Manage Payments – Checkout where you can click Pay Now. Alternatively please call 01462 442344, select
option 2 to pay by Debit/Credit Card over the telephone.
Credit Card payments are subject to a 4% charge & Debit Cards at £0.25 pence per transaction
England Netball
Taster Rate Participants Form 2015/16
Netball ID
(if known)
First Name
Last Name
Registration
form
(Please tick)
Please return with a completed England Netball Registration form for each individual to:
Membership Dept., Netball House, 1-12 Old Park Road, Hitchin, Herts, SG5 2JR.
If you have any queries, please visit our website www.englandnetball.co.uk, or contact us:
T: +44 (0)1462 442344 F: +44 (0)1462 442343 E: [email protected]
England Netball Registration Form, available to download from
http://www.englandnetball.co.uk/membership/membership_fees_and_forms
England Netball will not be able to affiliate your participants unless the forms are submitted with
this application form in accordance with Data Protection