Non-Former Pupil Application form

Name Address Postcode Telephone (Work) Telephone (Home) Email Home Course (if applicable) Handicap (if applicable) Date of Birth Summary of Heriot Connection Member of (sister club) Membership duration in years

This application form must be accompanied by a Standing Order Mandate set up to pay an annual subscription of £20.

Non-former pupils or current members of staff must be proposed and have their application supported by 5 current members of the club.

Proposer and Supporters

Proposer Supporter 1 Supporter 2 Supporter 3 Supporter 4 Supporter 5