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CCBA APPLICATION FOR MEMBERSHIP FOR 2011

 

NAME:----------------------------------------------------------------------------------------------------------------------

 

ADDRESS:------------------------------------------------------------------------------------------------------------------

             -------------------------------------------------------------------------------------------------------------------

             ----------------------------------------------------------POSTCODE:------------------------------------------

TEL:-    ----------------------------------------------------------EMAIL:-------------------------------------------------

 

NUMBER OF BIRDS CURENTLY KEPT( FOR INSURANCE PURPOSES) ------------------------------------------

 

I ENCLOSE A CHQ/PO FOR THE SUM OF £ -----------

 

To comply with the Data Protection Act , please indicate if the CCBA can share this information with likeminded avicutural bodies  YES / NO 

Please send completed form with remittance to:

The Secretary , CCBA .

13 Gorse Crescent , Ditton , Aylesford , Kent ME20 6ES.

 

                                                                                                                                 Click the print icon below.