HORSHAM Y.M.C.A. FOOTBALL CLUB

President: Mr G Head
HORSHAM Y.M.C.A. SPORTS AND SOCIAL CLUB
GORINGS MEAD, HORSHAM, WEST SUSSEX, RH13 5BP
Tel: Horsham (01403) 252689

Please reply to:

Chairman:
M BROWNING
44 Hillmead
Horsham
West Sussex
RH12 2PU
Tel:01403 252849

Vice Chairman:
J BIRCH
4 Luxford Close
Horsham
West Sussex
RH12 4DL
Tel: 01403 266345

Match Secretary:
R BRADING
16 Hazelhurst Crescent
Horsham
West Sussex
RH12 1XB
Tel:-01403 250270

Hon.Secretary:
J WALSHE
105 Merryfield Drive
Horsham
West Sussex
RH12 2AU
Tel: 01403 254578

HORSHAM YMCA FC 100 CLUB
Help the Football Club raise income by becoming a member of the 100 Club
Three prizes each month: 1st £25; 2nd £15; 3rd £10
The annual subscription is £36 which may be paid by cheque or cash in one amount or
By monthly payments of £3 by Bank Standing Order.
Please complete the following details and return this form together with your cheque,
Cash or Banker's Order Form to the Organiser:
E.Wright, 60 Undermill Road, Upper Beeding, Steyning
West Sussex, BN443JG (Tel: 01903-814797)

I wish to become a member of Horsham YMCA FC 100 Club and agree to pay
*monthly / yearly by *cheque / cash / banker's order+
(*Please delete as required) (+If paying by Banker's Order please also complete the Banker's Order Form below)
Cheques should be made payable to Horsham YMCA FC 100 Club

Signature: .…………………………………….. Name (Block Capitals): …………………………………………

Address: ………………………………………………………………………………………………………………

……………………………………………… Post Code: …………………… Tel No: …………………………….

BANKER'S ORDER FORM To: The Manager

………………………………………………………plc (Please fill in the name and address of your bank)

……………………………………………………………………………….. Post code: …………………………

Please pay to Barclays Bank plc, Branch code 20-42-58 for the credit of Horsham YMCA FC 100 Club

Ac No. 40107697, the sum of £…………. Every month commencing on 1st of…………………………

My bank branch code: …………………………… My account No: ……………………………………………

Signature: ……………………………………….. Name (Block Capitals): ……………………………………….

Address: ………………………………………………………………………………………………………………

………………………………………………………………. Post Code: ………………………