Membership Application Form
 

Please fill in what is relevant and send your subscription (£12.00 single, £15.00 family)
to the Treasurer, Sarah Owen, 44 Alden Close, Standish, Wigan, Lancs WN1 2TS.
Cheques should be made payable to "NWBAC"
Please contact any of the club officers on the home page for further information.
  Forename Surname  
Name Address:

Town:
County:
Postcode:
Country:
Family members
 
 
 
  Type of Membership requested: Single Family
       
  Telephone: home Telephone: work Telephone: mobile Email address
 
       
  Balloon Pilot?
..if so .. PPL CPL .?
LOR certificate no:
 Other ballooning qualifications
 

Balloon name:

 Type / Size:
 Balloon manufacturer:
 Balloon registration: