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