Membership Form for Mid-Ulster Walking Club

Name.        ______________________________

Address.   ______________________________

                  ______________________________

                  ______________________________

Tel: Home ______________________________

Mobile      ______________________________

E-mail       ______________________________

I enclose £ 20 .00 as membership fee for the year 2008.

Signed:    ______________________________

Please return to:                                                                                                                       
Mr. Alistair McConnell,                                                                                      
106 Moneymore Road,                                                                                  Cookstown,                                                                                                  Co.Tyrone,                                                                                                              
BT80 9UU

Or return to a committee member during a club walk.