North Of England Dexter Group Membership Form 2015 Type of Member Individual £10.00 ☐ Joint £15.00 ☐ Junior £5.00 ☐ PLEASE PRINT NAME(S) _____________________________________________ ADDRESS_____________________________________________ _____________________________________________________ _____________________________________________________ PHONE_________________MOBILE ______________________ E-MAIL_______________________________________________ AMOUNT PD___________ CHEQUES SHOILD BE MADE PAYABLE TO THE NORTH OF ENGLAND DEXTER GROUP And sent together with this completed form to: The Secretary Mrs A Gates, Low Carr Farm, Kirbymisperton Rd, Kirbymisperton, Malton North Yorks YO17 6XR MEMBERSHIP RUNS FROM 1ST JANUARY TO 31ST DEC . New Members joining after the 1st Sept 2014 will be paid up until 31st Dec 2016
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