Application for Membership

Application type New membership    Renewal      Membership No (if known)
Membership type (select) Individual, £5  Family, £7  Associate, £10
Family membership includes all members of one family at a single address.
Associate membership is available to organisations and businesses that wish to support our work.
Membership fees are for 12 months from date of joining.
   
Title    First name    Surname    Fields in bold are mandatory
Spouse/Partner    Title    First name    Surname 
Children

Please separate names with a comma
Address
 
 
Town
County
Postcode
Telephone
E-mail
   
Membership fee £
Donation £
Total amount to pay £

Please tick below if you are able to assist with any of these tasks:
Contributions to newsletter
Delivery of mailings
Cycle counts (0700 - 0900, twice a year)
Other occasional surveys
Assistance with events, such as during Bike Week in June
All members are welcome to attend the Campaign's monthly meetings.
Please let us know if you have any special skills or experience that might assist the Campaign.
I/we cycle for: Commuting    Trips about town    Leisure    Sport

Pay Now on-line  
or Print this form and send with your cheque to:
John Franklin, 201 Prestbury Road, Cheltenham, GL52 3ES.
 Cheques payable to Cheltenham & Tewkesbury Cycling Campaign

Membership enquiries

Data Protection Act: The information provided above will be stored electronically by Cheltenham & Tewkesbury Cycling Campaign.
It will be used solely for Campaign administration and not disclosed to any third party.

 

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