_________________________________________________________________________Please copy and then paste this page into a word processing document, complete and print form.
Send after nominations have been obtained to the General Secretary, with a cheque for £10-00 payable to the Probus Club of Surbiton.
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When completed, please return to:
Brian Jackson - General Secretary, Surbiton Probus Club
11 Pine Walk, Surbiton, Surrey, KT5 8NJ - Telephone - 0208 399 1811
Surname
Forenames
Preferred Name (if not first forename)
Address
Post Code
Tel. No. Date of Birth
I would like to become a member of Surbiton Probus Club.
Before I retired, or partially retired, my profession or business was
I agree with the objects of the Club, which are:
To foster good fellowship among its members and to engage in other activities, neither political nor sectarian, as members shall agree.
I have no objection to the Membership Secretary and General Secretary keeping the above personal information on a data retrieval system, provided that it is not communicated to any person who is not a member of Surbiton Probus Club.
Signature Date
Proposed by
Seconded by
Date of Admission
IT WOULD BE HELPFUL IF YOU WOULD GIVE, ON THE BACK OF THIS FORM, BRIEF DETAILS OF YOUR CAREER, HOBBIES AND INTERESTS TOGETHER WITH THE NAME OF YOUR SPOUSE/PARTNER, WHERE APPROPRIATE, (for use with invitations to events and Ladies Lunches etc.)
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