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Membership Application Form

 

Vintage Radio - Membership Application form downloads

Download a Word compatible version of our membership application form by clicking here.

If you want to use our on-line contact form then click here

 

Please note: the form below can only be printed out and then sent to us.

To print it click on the print icon under the title.

 

 

 

 

newlogo_cropped_thVintage Radio - Membership Application form

 

 

 

 

 

Personal details:

 

(Mr, Mrs, Miss, Ms – select applicable)

 

First Name

 

Surname

 

 

Address: Area of interest / expertise, tick one or more:

 

House name/No.

 

Address 1

 

Address 2

 

Town / City

 

County

 

Country

 

Post Code, ZIP code etc.

 

 

Making, producing and presenting radio programmes

Technical support

Marketing and Publicity

Fund Raising

Administration

Other – please specify

 

Contact details:                                                                                       Address for membership payments:

 

Telephone no.

 

Mobile no.

 

email address

 

Vintage Radio

c/o YMCA

Hope Prospect

56 Whetstone Lane

Birkenhead

Wirral

CH41 2TJ

 

Membership type:

Full Associate Please tick applicable option.  Membership=£30 per annum

 

Are you happy to receive communications e.g. newsletters etc. via email and your details to be held electronically on our membership database? (see Note 1 below)

 

Please note:

 

Full membership entitles you to vote in Vintage Radio meetings e.g. AGM, become a committee and / or    management team member and broadcast. Associate membership only allows you to broadcast. Both  options  include a mandatory contribution to our necessary insurance cover.

 

I agree that any programmes which I make for Vintage radio can be passed to other stations for transmission with the proviso that no significant change is made to the content by editing, taking extracts, shortening or adding to the material without my specific agreement.

 

 

Or I do not wish any of my material to be used on any radio station other than Vintage Radio.

 

(please fill in and delete as appropriate)

 

Signature Date

 

Notes:

  1. All data will be kept in a database and will not be used for any other purposes than communications from Vintage Radio. The data will not be passed to any 3rd parties.

  2. All applications will be reviewed by the management committee.

Application approved? (VR management team use only)