APPLICATION TO JOIN GLOUCESTERSHIRE OLD SPOTS PIG BREEDERS’ CLUB PLEASE COMPLETE IN BLOCK CAPITALS *delete as necessary. Title ………………………….. First Name(s)……………………………………………… Surname …………………………………………………………………………………………. Address……………………………………………………………...................................... ……………………………………………………………………..Postcode ………………….. Tel…………………………………….. Mobile ………………………………………………… Email address ................................................................................................ Do you keep GOS pigs? YES/NO* If yes are they registered? YES/NO* Are you a member of the British Pig Association YES/NO* If you are your HDL is …………………………. Subscription for individual members with pigs £20.00, Family/joint members with pigs £25.00, Associate members without pigs £15.00 and Overseas membership £25.00 (Take newsletter by email & tick here …… to deduct £5 ) I/We apply to join the Gloucestershire Old Spots Pig Breeders’ Club and enclose a cheque/postal order made payable to GOSPBC for £25.00/£20.00/£15.00/£10.00* being the subscription until 1 st November next. Signed ……………………………………….. Date …………………………………… If you wish to pay by standing order please complete the attached standing order form and take it to your bank to action. If you are joining the club as a pig keeping member and you do not wish your details to be given out to enquirers looking for pigs or placed on the website please tick the box. Return this form to: GOSPBC c/o Fowgill Farm, Ingleby Arncliffe, Northallerton, DL6 3JU GOSPBC SUBSCRIPTION STANDING ORDER FORM PLEASE COMPLETE IN BLOCK CAPITALS To the Manager………………………………………………………..Bank Plc Address …………………………………………………………………………………... …………………………………………………………Postcode ……………………… Please pay the sum of *£25.00/£20.00/£15.00/£10.00 now & then annually on the 1st November until further notice quoting ref GOS Subs/………………# from my account no ……………………………. Sort code……………………. In the name of ………………………………………………………………….to the Gloucestershire Old Spots Pig Breeders Club c/o HSBC, 2 Market Place, Cirencester, Gloucestershire GL7 2NS Sort code 40-17-25 Ac No 81164406 Signed ………………………………………. Date ……………………………… *delete as applicable #put your surname Gloucestershire Old Spots Pig Breeders’ Club C/o Fowgill Farm Ingleby Arncliffe Northallerton North Yorkshire DL6 3JU Tel 01609882773/07979858757 Membership/Subscription Contact Mandy Garbutt