MEMBERSHIP APPLICATION FORM

About Membership 
North Fylde Photographic Society is a club that is open to everyone who accepts the Club rules
We meet in the Cleveleys United Reformed Church Hall on Rossall Road, Cleveleys (just opposite the West Drive tram stop) every Tuesday evening at 7.30 pm from the first Tuesday in September until the last Tuesday in April. Have a look at our website for details of the season’s programme of events (www.northfylde-ps.co.uk).
 As well as obvious details such as your name and address, we would like to have some information about your photographic skills. This will help us to understand your needs better. Rest assured, complete novices are just as welcome as experienced photographers. You can post this application form to the Membership Secretary (see below for details) or simply bring it along on a club night.
Our membership year commences in September and the annual membership fee is payable that month. The current membership fee is £35 for Adults and £6 for Juniors (under 18s)* and students in full time education. There is also a £ 1 charge per person each night you attend the club. Cheques should be made payable to “North Fylde Photographic Society”. (If you join after the 1st of January, the fee is halved for the rest of the season.)  Alternatively, you can come along and try us as a visitor for just £2 a night. 
[* Please note that Junior members (and any visitors aged under 18) must be accompanied at all meetings by a parent, guardian or an adult with the specific agreement of the parent or guardian.]
MEMBERSHIP SECRETARY 
NEIL PASCOE
Address: 17 Molyneux Place, Lytham St Annes FY8 4PY
Email: neilrpasc@me.com
Phone: 01253 734243
[* Mandatory information]
•	NAME* :

	Title* 			Mr / Mrs / Miss / Ms / other ________________________

	First Name*		______________________________________________

	Last Name*		______________________________________________

•	ADDRESS * :

	House name/no*	______________________________________________

	Street	*		______________________________________________

	Town/Village* 	______________________________________________

	Post code*		______________________________________________

•	EMAIL :		______________________________________________

•	PHONE * :		______________________________________________

•	MOBILE :		______________________________________________

•	DATE OF BIRTH (if under 18) * :	_____________________________

•	ANY PHOTOGRAPHIC EXPERIENCE ? :

 	How do you rate your skills on a scale of 1 to 5 where "1" is beginner and "5" 	proficient ? If you have any photographic qualifications, please add these. 					
            ___________________________________________________________________

	Do you belong, or have you previously belonged, to any other camera clubs?*   												Yes/No
		If Yes, which club(s)?  ____________________________________________

		________________________________________________________________

•	AND FINALLY ! :

How did you hear of us? 	______________________________________________

Please feel free to add any message regarding your application if you wish. 

I wish to apply for membership and agree to abide by the Club’s constitution and rules.

Signed ……………………………………………………..      Dated .........................................