FORTY-NINE CLUB 

MEMBERSHIP APPLICATION

Name _____________________________________________________

Occupation _____________________________________________________

Business Name and Address_______________________________________________

                      ______________________________________________________ 

Home Address ______________________________________________________

                          ______________________________________________________ 

                                                                              address for Club mail ?

Contact details        ‘Phone number:-

                                  E-mail address:-

Name of Proposer    _________________________________________

Proposer’s signature _________________________________________

The proposer must NOT BE Committee member

Please give brief details of Licensed Trade connection______________

_________________________________________________________

                                        I enclose cheque for £ 79.00

                    (Entry fee £10 / £ 49 annual subscription / £20 tie/scarf )

          Signature ______________________________

          Date          ______________________________

The Forty Nine Wine and Spirit Club of Scotland manages the funds of

The 49 Wine and Spirit Educational Trust.

Charity Registration Number:- SC043306

Completed form to :- Richard Barbour; 49 Club; P.O. Box 30011; Killearn; G63 9WJ