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TITLE /RANK NO
FIRST NAME SURNAME
DIVISION
SECTION /DEPARTMENT
HOME ADDRESS (If retired)
I wish to joinDivision Sports & Social Club
I authorise to be deducted from my pay/pension each month/fortnight in respect of membership to the Lancashire Constabulary Sports and Social Club.
Note: Monthly subscriptions are: £2.00 per month - Southern, Eastern and Pennine - £2.25p Western and Northern Division - £2.50p Central Division £4.75p Headquarters
SIGNED ............................................................................................................................
DATE
PAY / PENSION REFERENCE NUMBER (IF KNOWN)
Sign and return this form by post to:
PC Steven Broadbent, (Club Membership Secretary) Carnforth Police Station, Haws Hill, Carnforth. LA5 8LY. (By internal post)
