SILVER CONNECTIONS

APPLICATION FOR MEMBERSHIP

 

PLEASE PRINT OUT, COMPLETE IN INK AND POST TO:

Silver Connections

PO BOX 149

THIRSK

YO7 4WQ

 

Please use block capitals and give as much detail as possible – this application is designed for you to describe yourself as you would like others to see you.  It is also designed for you to give details of the person you would like to contact.

 

Title ________                                                                                                 

 

Text Box:           Insert Photo Please (optional)

 

Surname   __________________________

 

 

Forenames _________________________

 

Address ____________________________    

 

____________________________________ 

 

____________________________________ 

 

Post Code __________________________ 

 

Tel. No  ____________________________ 

 

E-mail _____________________________ 

 

Date of birth ________________________    

 

Marital status _______________________   Nationality _____________________ 

 

Occupation  ______________________________ (If  Retired write ‘Retired’ and state previous occupation)

 

Educational level _____________________ Church attended ________________

 

Dependants – number ________    Age   ____________ Living at home:  Yes/ No

 

Height _________ Build _________ Hair Colour _________ Eyes _________

 

 

Do you    -    Smoke    Yes/ No                 Do you drink    -    Yes/ No/ Occasionally

 

 

If you do not attend church regularly, do you live according to Christian values and principles?  Yes/ No.   

 

 

Please tick six of the boxes below to indicate which are most applicable to you:

 

Homeloving

Friendly

Loving/Caring

Reserved

Honest

Good Listener

Outgoing

Considerate

Positive

Intelligent

Sense of Humour

Practical/Creative

 

 

Please complete this space to give further details about yourself:  e.g. love of music, sport, travel, animals, church activities, gardening.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

About the person you would like to meet:

 

Age range :

Has children :

Marital status:

Different nationality:

Height:

Physical disability:

Build:

Church denomination:

Smoker:

 

 

 

Please complete this box to give further details of the kind of person you would like to meet,  together with any special qualities.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEMBERSHIP AGREEMENT

 

MEMBERSHIP COSTS

 

Membership for 6 months: £50  Membership for 12 months: £80

 

I wish to join Silver Connections for: One year/ six months.

 

I enclose a Cheque for ___________ made payable to Silver Connections; this is non-refundable.

 

I realise I may have to travel to meet the person of my choice.

 

I would be prepared to relocate if I met the right person: Yes/No.

 

 

I heard of Silver Connections through: ________________

 

Please send details to my friend, details as follows:  ______________________

 

___________________________________________________________________

 

___________________________________________________________________

 

I Confirm:

 

a. I will abide be the membership and conditions of Silver Connections.

 

b. I live according to Christian values.

 

c. I am free to marry.

 

d. The information I have given is correct, and can be published in the Silver Connections Register.

 

 

Signed:  ___________________________ Date:  ___________________________

 

 

Name:  (BlockCapitals) _______________________________________________

 

ON COMPLETION OF YOUR AGREEMENT WE WILL SEND YOU FULL DETAILS INCLUDING A SUGGESTED PROFILE OF YOURSELF BY POST

 Register and Monthly Updates: Silver Connections will send you Register of members of the opposite sex soon after you have completed membership documentation. Thereafter, you will receive a monthly update of your Register. This can be done by post, or, if you have email, by e mail. Please state which method you prefer: by post/by e mail delete one'