BNHIVC Full Membership Form

APPLICATION FOR FULL MEMBERSHIP

Prospective members of Basingstoke & North Hampshire IVC must have attended at least three activities and be known to two committee members before an application for membership can be considered.

Mr/Mrs/Ms	Forenames	Last Name
Address
		Home Phone
		Work Phone
		Mobile Phone
Email Address		Date of Birth ___/___/19___ Sex M / F
A membership list is produced several times a year. Please tick below those details that you DO NOT want included with your name. Address: ______ Home Phone: ______ Email Address: ______

Member of another Inter-Varsity Club ? Yes / No

if yes, which?

Three events you have been to and obtained officer signatures at those events:
1.	Officer Signature:	Date: ___/___/____
2.	Officer Signature:	Date: ___/___/____
3.	Officer Signature:	Date: ___/___/____

PLEASE UNDERLINE BELOW ANY ACTIVITIES BELOW YOU ARE PREPARED TO ORGANISE.
ARTS & INTERESTS Cinema Theatre/Drama Books/Literature Visual Arts Museums/Galleries Buildings / Architecture Arts and Crafts Clothing and Fashion Visiting/Discovery	OUTDOOR Camping/Hostelling Travel (UK & Abroad) Walking/Climbing Water Sports Equestrian Flying & Aviation Motor Sports Snorkelling/Sub-Aqua Pitch & Putt (Golf)	SPORT Badminton Squash Tennis Cycling Swimming Athletics Cricket Football Rounders	MUSIC & DANCE Barn Dance Modern Jazz Jive Jazz, Blues, & Soul Classical/Opera Pop Music Nightclubs/Discos Karaoke Comedy Clubs Concert Tours	LEISURE Dining Out/Dining In Pub Nights Games/Quiz Nights Skittles Evenings Ten Pin Bowling Ice Skating/Skiing Treasure Hunts House Parties Disco/Music Cruises

Data Protection Act: The information supplied on this form will be stored on a computer to facilitate bulletin distribution and club administration. Your signature below will be taken as permission for this.

I/we hereby apply for Membership of Basingstoke & North Hampshire IVC. I/we agree to abide by the rules of the club as laid down in the Constitution and Club Rules of Conduct, which are available for inspection on the BNHIVC web site at http://www.bnhivc.org/defaultAbout.htm and on application to the Secretary. I/we agree to organise at least two events per year towards the club programme.

I/we enclose the relevant subscription and understand that this will be returned if this application for membership is not accepted by the Committee of Basingstoke & North Hampshire IVC. I/we acknowledge that Basingstoke & North Hampshire IVC reserves the right to refuse this membership application without assigning any reason.

Signed	Date
Return form to: Ian McCormack, BNHIVC Membership Secretary (membership@bnhivc.org) 3 Apple Dene (End of Coopers Lane), Bramley, Hampshire RG26 5JU (07776-188015)