MEMBERSHIP FORM

Please complete the form below to renew or initiate a new membership. Indicate the type of membership you require: Full, Family, or Student. The prices for each membership type are listed below. A printed version of this form can be provided upon request. Kindly submit this form along with your payment, which can be made by cheque, cash or bank transfer (please indicate your preferred method below).

Title

First name

Last name

Phone

Age if under 25

Multi-line address

Country/Region

Address

City

Zip / Postal code

Musical Interests

Please note that by completing this form you are agreeing to your details being held on the club's database for club purposes only.

Please select membership category required

Single: £15 per year

Couple/Family: £25 per year

Student (under 25 years old): £10 per year

Please indicate preferred method of payment

Cheque made payable to B.R.M.C and a stamped addressed envelope to The Secretary, Louise Russell, 25 Bostock Road, Chichester, PO19 6UL

Electronic payment to B.R.M.C, Sort code: 60-05-24, Account no: 16195213, quoting BRMC and your first and last name in the reference

Cash by alternative arrangement with The Secretary

Please indicate below

If you would like assistance with transport to and from concerts

If you can offer with transport to and from concerts

If you wish to support the running of the club, e.g. by helping with refreshments, setting up and clearing the hall, taking money on the door, please indicate what help you could offer below