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   Bee
Instrumental
Insemination
Group

Membership Application Form

Title: (Mr. Mrs. Miss Dr.):  First Name:  Initial: 
Surname: 
House Name or No.: 
Street: 
District: 
Town or City: 
County:  PostCode:  -
Phone: 
Mobile: 
Email: 

 

Sign up:Time:Price:Method of Payment
 Membership1 Year£10.00 Cheque made payable to.
Bee Instrumental Insemination Group

 

I wish to apply for membership of the Bee Instrumental Insemination Group, and agree to adhere to the rules of the Group.

 

Signed..................................................................................


Date........................................

 

Please print direct from your browser.
Send the completed form
along with your remittance to the
Membership Secretary and Treasurer... 
 


Dave Cushman

        50 St. Peter's Street
        Syston
        Leicester
        LE1 7HJ

Phone: 0116 260 2527
Email: dave.cushman@lineone.net

 

 

Written: 13 Dec 2006,
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