To: The Membership Secretary, Orpington Liberal Club, 7 Station Rd, Orpington, Kent BR6 0RZ
I/we wish to join Orpington Liberal Club.
Name(s) ��������������������.�����.���.������
Address ����������������������������...���..�...�
Postcode �������.�� Telephone ���.�.���� Car Reg �����..�...�
E-mail..............................................................................................................................
Lib Dem Membership No�������������Constituency �������.��.
How did you find out about the club? ���������������������.��
Cheque (payable to 'Orpington Liberal Club') or cash enclosed ��������..�����.
[Annual subscription: �15, joint membership �25: senior citizens, students & unwaged �9, or joint �15]
Proposer ������....................��(signed) Seconder ���..����������(signed)