Please print a paper copy of this form and post to the address below.

THE MIDLAND LHASA APSO ASSOCIATION

MEMBERSHIP PROPOSAL FORM

Hon Secretary:

 Mrs Joan Scarll
The Turbary
Belton
Nr Doncaster
South York's
DN9 1PL

Tel:

 01427 872615
Name(s):  
Address:  

 

 
Post Code:  
Tel:  
I/We the undersigned request that my/our name(s) be set before the Committee for election as a member/joint members of the Midland Lhasa Apso Association.  I/We agree to promote the welfare and uphold the recognised standard for the Lhasa Apso and abide by the rules of the association.  I also agree that my/our details i.e. Name(s), Address, Telephone number and Affix to be kept on computer disc.
Usual Signature(s):
Date: Affix (if applicable):
This form to be completed and forwarded with the appropriate fee to the Hon Secretary.

New members must be proposed and seconded by existing members of the association.
PROPOSED BY:  
Print name in block letters  
SECONDED BY:  
Print name in block letters  
FEES to be enclosed with this form:

Single member £6.00, joint members £8.00, overseas £10 sterling, junior member up to 16 years of age £1.50

All cheques and postal orders should be made payable to The Midland Lhasa Apso Association or The MLAA.