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Membership Inquiry

Proposal


All fields marked with an asterisk(*) are mandatory.
Title*:
If other, please enter:
Surname*:
Forename and initials*:
Date of birth*:
Decorations or Qualifications (e.g. OBE):
Spouse's or partner's name (optional):
Private address*:
Post Code*:
Business address:
Post code:
Landline tel. no*:
Mobile no.:
Alternate tel. no:
E-mail address*:
Bank Details (for collection of Annual Subscription by Direct Debit)
Current occupation/ profession* (e.g. farmer, landowner, banker, adviser, supply trade):
Bank*:
Name of account*:
Account Number*:
Sort code*:
Type of membership:
Status:
*Family status entitles spouse/partner and children under 18 to independent use of Club);Family (entitles spouse/ partner and children under 18 to independent use of Club
If Family Membership is applied for, please complete
Spouse/ Partner:
Date of birth:
Mobile no:
E-mail:
Child 1:
Date of birth:
Child 2:
Date of birth:
Farming, fish farming or countryside connections. Please use this space to provide up to 100 words detailing your main farming and countryside activities or connections - for example: acreage owned, farmed or managed; role in agribusiness; cropping; livestock kept; food products supplied; qualifications; posts held; and membership of other professional organisations, club or societies.
Description:
Sponsors To apply for membership you must be sponsored by two current Members of the Club. Please give the names, email addresses and daytime telephone number of your sponsors, state how long they have known you and ask them to sign the form. The proposer should also provide a statement supporting the application, outlining the contribution the applicant to the Club and the applicants involvement in farming or commitment to the farmed environment. If a sponsor is not able to sign the form in person, he/she will be contacted by the Membership Secretary by telephone or email.
Name of proposer*:
E-mail*:
Daytime tel. no(s)*:
Years applicant known to sponsor*:
Supporting Statement:
Name of seconder*:
E-mail*:
Daytime tel. no(s)*:
Years applicant known to sponsor*:
For more information about the Club The Clubs website is at www.thefarmersclub.com Both a leaflet about the Club and details of the current subscription rates and entrance fee are also available on request from the Membership Secretary - telephone 020 7925 7102 or email membership@thefarmersclub.com