East of Scotland Association for Wildfowling & Conservation

Application for Membership

Surname…………………………………   Forenames…………………………..………………

Full Postal Address  ………………………………………..………………………..……………

 …………………………………………………………………… Postcode………..…………....

Home Telephone Number……………………………  Mobile…………..……………………….

E‐mail Address (please write clearly) ………………………….…..…...................……………

 Are you currently a member of BASC?                                                           YES / NO

( If yes please give BASC number ………………………………………..)

 Do you have a current shotgun certificate?                                                      YES / NO

Are you currently a member of any other wildfowling club?                           YES / NO

 Please name other club(s)………………………………………………………………………………

 …………………………………………………………………………………………………….…….

Type of membership applied for (please delete as applicable)

Full Membership:  £66 per annum & Entrance Fee of £20   Total £86.00p ( Due to BASC affiliation fee this can vary according to time of year you join, the £66 is for full 12 months BASC dues. )

Junior Membership:  £22 (Under 21 at time of joining: This includes BASC Young Shots membership.)

Supporter Membership:  £20 per annum (does not include BASC membership)

· If you are un-employed and in receipt of Job-Seekers allowance please contact us for special rate of membership.

Please complete this form, taking care to complete all sections, and send it with your 

cheque (payable to East of Scotland Association for Wildfowling & Conservation)  to address below.

Signed:………………………………                   Date:………………………………

East of Scotland Associaton for Wildfowling and Conservation, 45b Blairs Road, Letham, Angus, DD8 2PE