100 Club Application Form
I/we apply for membership of the Chess Scotland 100 Club
and wish to purchase ____ units at £1 per unit over ____ months.
I/we agree to abide by rules as set by Chess Scotland.
Post Code: _____________
Your Signature: _________________________________________
Payment Enclosed: ______ (pounds - in multiples of 12) for ___ year(s)
Standing Order: I have sent a standing order to my bank ______ (tick)
Please post this form to:
Chess Scotland Treasurer, David Congalton, 12F Townhead, Irvine, Ayrshire, KA12 0BE (Tel:01294 273114)