To: WDUAA   Applicants Name:
  c/o R. Ravenall   Applicants Address:
  38 Defford Close,    
  Webheath, Redditch,    
  Worcestershire B97 5WR    


Please provide me with Membership/Permit as selected below for the sum of:
Please Select One
1) Honorary Full \ Senior £ 30.00 (16-65 yrs)
2) Concessionary (OAP’s, Juniors under 16 and disabled)  £ 20.00
3) Day Permit £ 6.00  
(date of required day permit)
Total cost


Please find cheque for the sum of made payable to WDUAA

Please provide a stamped addressed envelope for issue of Membership/Permit

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