Join The 100 Club

100 Club Application Form

I wish to become a member of the Baildon Golf 100 Club

Name (or names if applying for more than one number under different names):  ............................................................................................................................................................................

Address (for membership and prize payment):  ............................................................................................................................................................................

......................................................................................Phone Number:.........................................................

Email:………………………………………………………………………

How many numbers would you like to enter in the monthly draw at £120 per year? ..................

I agree to be bound by the rules of the club, and confirm that I am over 18 years of age 

Signed ....................................................................................  Date .........................................................................

              I enclose a cheque for the first full year of membership paid to the Baildon Golf 100 Club for £120

              I wish to pay by monthly standing order and have forwarded the completed mandate form to my bank for processing

Please return this part of the form in an envelope marked 100 Club, to the The Secretary, Baildon Golf Club, Northgate, Baildon BD17 5PP for collection by the organiser

Standing Order Mandate

To: The Manager   (Name and Address of your bank) ........................................................................................................................................................................................................................................................................................................................................................

 Please pay to Yorkshire Bank, Baildon Golf 100 Club (Account Name)

Sort Code 05.01.50             

Account Number 55235690

The sum of £ .................. (£10 per month per draw number)

Starting on the 15th day of ..................... 20.. and monthly on the 15th day thereafter until further notice.

 Account Name/s: ......................................................................................

......................................................................................

Sort Code: ................................................................

Account Number: ......................................................................................

Signed: ......................................................................................

Date: ......................................................................................

Address: ..................................................................................................................................................................................................................................................................

Please return this part of the form to your own bank for processing