Application Form for SEFAN

Please print out and complete, IN BLOCK CAPITALS, then post with your subscription to:
Penny Allen, General Manager, SEFAN , 89 Hollingbury Park Avenue, Brighton BN1 7JQ
Please make cheque payable to SEFAN
OR *** NEW *** for 2008
JOIN and PAY ONLINE via Electric Voices site HERE
.pdf version Word.doc version
§ Contact us for Bank Mandate YEARLY 5-YEAR option
5yrs for the cost of 4!		 Standing Order
INDIVIDUALS / CLUBS /BANDS/GROUPS / SMALL ORGS.
£15
£60
£12
LARGE ORGS./ FESTIVALS / FUNDED BODIES
£45
£180
£36

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Organisation, Club, Band etc.(if applicable): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Post Code: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Home Tel: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Work Tel: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mobile Tel: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Website: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Activity / Folk Interests: Please continue on back / 2nd sheet if needed.
This information will be held on a database and made available to others in the Network.
Contact information other than your postal address will also be displayed on our directory web page.
PLEASE CROSS OUT below any other details you wish to be WITHHELD from this page.
1. Name
2.Tel No.
3. Email address
4. Website URL
I am willing for this information to be available to legitimate folk related enquiries.
Signed: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .