MEMBERSHIP APPLICATION
Name……………………………………………………………………………..
Address………………………………………………………………………..…
…………………………………………………………………………………..….
Post Code……….……….. Telephone ……………………..
Facsimile………….……… Mobile…………………………...
e-mail……………………………..………………………………..
I apply for FULL / SOCIAL / ASSOCIATE / JUNIOR* Membership
*Delete as appropriate
I enclose the Membership Fee / Donation of £ ……..
(see here)
Signed ………………………….………………………….. Date …../…../………
Please send completed applications to:
Treasurer, Positive Action Group,
C/O 26 Manor Drive, Farmhill, Douglas IM2 2NS
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