Please print this page then complete the form

Ripley Blues Club

APPLICATION FOR MEMBERSHIP
(use block letters please)

FULL NAME  
E-MAIL ADDRESS  
ADDRESS

 

 

 

 

Date of Birth  

 

I apply for membership of the RipleyBlues club.

 

Signature of Applicant

 

 

Date Signed

 

 

Please post this form with a cheque for £15 (payable to RipleyBlues) to
RipleyBlues Club, c/o Bailey Motte Cottage, 1 Foundry Gardens, Knaresborough HG5 8BB