EmailMe Form - ADULT MEMBERSHIP APPLICATION/RENEWAL 2020

Title: (Mr, Mrs, Miss, Other)

Initials

Name *

First Last

Street Address *

Address

Town *

County *

Post Code *

Mobile Telephone Number *

11 digits no spaces

Home Telephone Number *

11 digits no spaces

Email *

Date of birth

DD / MM / YYYY

Spouse/Partner details (if applying for Joint Membership)

Title: (Mr, Mrs, Miss, Other)

Name

First Last

Additional Handbook required (please select)

Membership Category

Please tick as appropriate *

Full Member - £25

Full Joint Membership (with spouse/partner) - £40

Senior Citizen Member (over 65) - £20

Joint Senior Citizen Membership (with spouse/partner) - £30

Life Member - fee structure below

Life Membership - One single payment

Aged Under 50 - £375

Aged 50-64 - £325

Aged 65 and over - £275

Payment

I have added £15 for an HCCA necktie

Tick if appropriate

Payment method *

Details of how to make your payment will be sent by email confirmation once you submit your form.

Data Protection Statement

HCCA will hold details of its members for the following purposes:
For maintaining records / for ensuring mandatory requirements of the ECB are satisfied /to provide and administer your membership / for historical archives. We will only contact you by the following methods of communication, post/email, with information and offers of products or services that we believe may interest you. We will not share or sell your information outside of HCL. You are entitled to a copy of your personal data and to correct any inaccuracies in it.

Please tick to complete Data Protection Statement

I/We do want to receive information (opt in)

The Hertfordshire Cricket Limited Privacy Policy can be found on our website www.hertscricket.org