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CSSA No:
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CSSC No:
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Date of Birth:
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| A
- Please delete one of the following (i, ii) |
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| (i) I
apply for Full Membership of the Civil Service Sailing Association
(CSSA) and I agree to be bound by the Constitution and Rules of
the Association. I am currently paying for Membership of the Civil
Service Sports Council - Sports & Leisure (CSSC) and my membership
number is as shown above. I am linked to current CSSC member (if
applicable) |
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(ii) I
apply for Full Membership of the Civil Service Sailing Association
(CSSA) and I agree to be bound by the Constitution and Rules of
the Association. I enclose a completed CSSC form applying for
Membership of the Civil Service Sports Council (Sports and Leisure),
paid for i) by monthly deductions of £3.60 from my salary/£3.24
from my pension, or ii) by Direct Debit or annual cheque for forwarding
to the CSSC. I am linked to current CSSC member (if applicable)
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(iii)
I apply for Associate Membership of the Civil Service Sailing Association
(CSSA) and I agree to be bound by the Constitution and Rules of the
Association. I understand that this application must be sponsored by
an Officer of one of the Divisions or Clubs which form part of the CSSA,
and that this sponsorship is renewable annually on payment of an Associate
Member Annual Subscription to the CSSA during January, currently set
at £52.00 per annum. I enclose a cheque payable to the CSSA for this
year.
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B - PLEASE COMPLETE
THE FOLLOWING
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| Title |
if other, specify
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| Initials |
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| Forename |
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| Surname |
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| Home Address |
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| e-mail |
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| Home telephone |
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| Office telephone |
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| Mobile |
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| Employer or CS Department
(eg BT, MOD) |
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| Site |
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| Professional / Personal
skills |
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| Sailing Qualifications
and Experience |
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| Boat owned: Name |
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| Class/Type |
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| Sail no |
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| Home Port/Club |
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| I am a member of the
following sailing/yacht clubs |
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| I wish to join the following
CSSA Clubs/Divisions (circle/underline) |
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| I require forms (Y/N) |
Yes
No
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C -
I understand and agree that the personal details on this form will be
held on a computer file, only to be disclosed to Committe Members of
CSSC, CSSA and their Clubs and Divisions as appropriate and necessary
for CSSA business.
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| Signature |
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| Date |
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Please return this form to CSSA Membership
Secretary, Ken W Pavitt, 14 Sussex Court, Vanguard Road, Gosport, Hants,
PO12 4FF. New CSSC members should also send the CSSC form for checking
and forwarding.
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