PLEASE WRITE in BLOCK CAPITALS or TYPE
(/) Delete where necessary

I/We wish to become a member/members of the Rex Cat Club.
I/We agree to promote the interests of the Club to the best of my/our ability.
I/We enclose £
Single Member : £6.00 Joint Members : £10.00 Junior : £2.50p

Name : Mr /Mrs /Ms /Miss /Mstr _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .}
Date of Birth (Junior applicant only): _{. . . . / . . . . / . . . .}
Address : _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .} Post Code : _{. . . . . . . . . . . .}
Tel. : _{. . . . . . . . . . . . . . . .} Fax. : _{. . . . . . . . . . . . . . . . .} Mobile : _{. . . . . . . . . . . . . . . . . . . . .}
Email : _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .} WWW. _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .}
Are you a Breeder/Owner of ? : Cornish/ Devon or Other Breed's : _{. . . . . . . . . . . . . . . .}
Prefix : _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .}
Signature : _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .} Date : _{. . . . / . . . . / ....}
Proposer : Name and Address : _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Signature : _{. . . . . . . . . . . . . . . . . . . . . . . . . . .}

Seconder : Name and Address : _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Signature : _{. . . . . . . . . . . . . . . . . . . . . . . . . . .}

NB. Both proposer and seconder must be paid up members of the club. In the absence of a proposer and seconder please obtain a letter of reference from your Veterinary Surgeon.
Membership details are recorded on computer for club use only.

Please send your completed form with remittance to the Membership Secretary.

Mrs S. Luxford-Watts.
Darby House,
Sunbury-on-Thames,
Middlesex.
TW16 5PJ.