PCA Membership Application Form

Family Name:	Given Name:
Address:
Other information you would like included in the year book:
Boat name:	Boat type:
Telephone number:	e-Mail:

New members are entitled to one back issue free, see the index of past issues.  Circle below the back issue(s) selected, additional issues must be paid for, see the information on back issues and merchandise.

13	14	15	16	17	18	19	21	22	23	24	25	26	27	28	29	30
31	32	33	34	35	36	37	38	39	40	41	42	43	44	45	46	47
48	49	50	51	52	53	54	55	56	57	58	59	60	61	62	63	64
65	66	67	68	69

Subscription	£20.00	Payment Date:
Back Issues		Total payment for any additional back issues circled above
Total		Subscription plus back issues

Visa and Mastercard only are accepted for credit card payments, please give details below:

Name of Card holder
Credit Card Details	Expiry Date:		Card number:
Card holder address if different from above:

Payment by Credit Card is also available by phone
Call Ken Hook + 44 (0) 1202 531445 [0800-1100 or 2100-2359 GMT],If you get the answering machine please try later. All other payment must be made by cash, cheque on a British bank or a cheque on a non British bank (e.g. Euro), if you send a non British bank cheque you must add £5 to clear it here!

Post to: PCA, 118 Howeth Rd., Bournemouth, Dorset, BH10 5NS, United Kingdom