Membership Application Form (Direct Debit)

TSSSC Ltd. Membership Application Form

(For members who wish to pay by Direct Debit)
Name*

First NameLast Name
Address*

Address 1

Address 2

Town/CityCounty

Post CodeCountry
E-mail*
Mobile Phone*

First 5 digitsLast 6 digits
Date of Birth*

DayMonthYear
I would like to apply for social membership of the Trinity Sanderstead Sports and Social Club (TSSSC) and I agree to abide by the rules of the club. Once my application has been accepted, I understand I can apply for a membership/discount card.

The following two existing members of the TSSSC or TMWA will act as my “sponsors” and I understand that they may be contacted to confirm my membership application. I have also indicated what (if any) connection I already have with the TSSSC or TMWA.
Sponsor 1*
Sponsor 2*
My Connection with TSSSC/TMWA is:*
Today's Date

MonthDayYear
I have paid by:

I have already completed a Direct Debit mandate for £25.00 (for initial sign-ups)
If you wish to pay by Cash or Cheque, please download a copy of this form and post the application form as described on the form.
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TSSSC Ltd. Membership Application Form