NORTHERN VETERANS ATHLETIC CLUB
I wish to apply for membership to N V A C for 2005
I enclose £8.00 (second claim) or £10.00 (first claim to include the North of England A A levy)
Cheque made payable to NORTHERN VETERANS A C & sent with a stamped addressed envelope to
Tina Lewis, 110 Grassington Road, Burnley, Lancs BB10 2SP
Mr/Mrs/Miss First Name.........................Last Name....................................
Address..........................................................................................................
..................................................................Post code..........................
Date of birth................................ Phone No............................................
1st Claim club.................................................................................................
Email address.................................................................................................
I agree to my details being kept on computer by NVAC & BVAF to allow news to be sent to my home address. Also for NVAC & BVAF to verify my eligibility to compete in veterans events
Signed..................................................Date.......................