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National Chinchilla Society
Application for Membership
Single, Joint or Partnership
1st July 2005 to 30th June 2006
£15.00 Single or Partnership (one voting member).
£22.50 Joint membership (two votes, one Gazette).
£20.00 Sterling for membership outside UK.
A partnership or joint membership is two persons only.
ALL APPLICANTS
Please fill in the form using BLOCK CAPITALS giving
Full Name, Address including Post Code and Telephone Number
MEMBER A
Name__________________________
Address________________________
______________________________
_______________Post Code_______
Telephone No. __________________
E-mail Address__________________
Membership No. (if known)_________
MEMBER B
Name__________________________
Address________________________
______________________________
_______________Post Code_______
Telephone No. __________________
E-mail Address__________________
Membership No. (if known)_________
ALL APPLICANTS PLEASE ANSWER THE FOLLOWING QUESTIONS:
Tick, delete or complete as necessary

1. To which region do you wish to be affiliated? Southern ( ), West Midlands & Wales ( ), Northern ( ),
or Scottish ( ). Members outside the UK will automatically be affiliated as International members.
2. May we divulge your Name and Telephone Number to persons requesting assistance in your area? YES/NO
3. Do you intend to show your chinchillas at NCS shows? YES/NO
4. Are you a member of, or associated with, any other chinchilla organisation? YES/NO #
5. How were you informed about the NCS? Society Member/Advert/Internet/Other. #
# Please give full details on the reverse of this form where necessary.

Should the elected committee approve your application for membership, you will receive Membership Card(s) for the current year together with a copy of the NCS Constitution and Show Rules. Back issues of Gazettes and Supplements, printed during the current membership period will also be forwarded. New members will also receive a set of Novice cards.

I/We hereby apply for membership of the National Chinchilla Society and agree to be bound by the Constitution and Show Rules of the Society.
Applicant (A) Signature ______________________ Applicant (B) Signature ________________________
Date ______________________ Date ________________________
All cheques to be made payable to the National Chinchilla Society and sent to the Hon. Secretary, National Chinchilla Society, 101 Simmondley Lane, Glossop, Derbyshire. SK13 6LU.
Standing Order
Please pay to the account of the NATIONAL CHINCHILLA SOCIETY. Midland Bank PLC. Cowbridge.
South Glamorgan. SORTCODE 40-18-18. ACCOUNT NUMBER 31529110. the sum of ** Fifteen
pounds (£15) / Twenty-two pounds and fifty pence (£22.50p) / Twenty pounds (£20) immediately
on receipt and then on the 1st July annually thereafter. ** Please delete those that do not apply.
For the Bank. Please quote the reference number when processing. REF No.________ for office use
ACCOUNT NAME ____________________________________ ACCOUNT NO. _________________
NAME OF BANK _____________________________________ SORT CODE. __________________
BANK ADDRESS _________________________________________________________________
______________________________________________________________________________
SIGNATURE _____________________________ DATE ______________
Please send completed order to Hon. Secretary, National Chinchilla Society, 101 Simmondley Lane, Glossop, Derbyshire. SK13 6LU