THE ASHCOMBE
DORKINIAN ASSOCIATION
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I wish* / do not wish* to become a member of The Association Please
complete ALL sections and return the ENTIRE page To The A.D.A. Membership Secretary: Ted Hazelden, 23 Dunsdon
Avenue, . GUILDFORD, GU2 7NX, or via Mr James Robinson, Head of Sixth Form |
Address : …………………………………………………………………………..
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Post Code: ………………………………..
Years at School
From ………… to ………….. |
We send ADA Newsletters via Email if
we have an address for
you . (About 2 or 3 times a year)
Email Address:
………..……………………………………………………………….
I wish*/do not wish* my email address to be published in the Association
Membership List |
Telephone number ………………………… this is for
office use only and will NOT be published) |
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I am* / I am not* applying for the ADA Bursary Award this
year. |
Any comments you wish to make: |
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Your Signature Date |
New member form Mar 2010