Membership Renewal Form (Direct Debit)

TSSSC Ltd. Renewal 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 wish to renew my 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.
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.
Enter the message as it's shown*
Should be Empty:

TSSSC Ltd. Renewal Application Form