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
JOIN and PAY ONLINE here (via Charity Business)
.pdf version Word.doc version
§ Contact us for Bank Mandate for Standing Order ... or do it online if you have online banking. (please ask for your membership no. for our reference 1st) YEARLY 5-YEAR option
5yrs for the cost of 4!
INDIVIDUALS / CLUBS / BANDS/GROUPS / SMALL ORGS.
£16
£64
LARGE ORGS./ FESTIVALS / FUNDED / COMMERCIAL
and/or with paid staff etc.
£48
£192

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:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .