*Club Affiliation Fee             £ 7.00    :  £                       
*Insurance Fee SORRY INSURANCE NO LONGER AVAILABLE THROUGH LCNWBS  PLEASE EMAIL The Secretay for advise  
*Total Amount Enclosed                    :  £                       

                                              Name of Society:                                                                                               

Name & Address of Club Secretary:                                                                                                                                      
*                                                                                                                                                                                                    
*                                                                                                                                                                                                    
POSTCODE:                                                                     PHONE:                                                                                         

Name & Address of Show Secretary:                                                                                                                                    
*                                                                                                                                                                                                   
*                                                                                                                                                                                                   
POSTCODE:                                                                     PHONE:                                                                                        

Name & Address of LCNWBS Delegate:                                                                                                                             
*                                                                                                                                                                                                   
*                                                                                                                                                                                                   
POSTCODE:                                                                     PHONE:                                     RING NO                                  

SOCIETY INFORMATION FOR PUBLICATION:
MEETING PLACE:                                                                                                                                                                  
MEETING DATES:                                                                                                                                                                  
SHOW DATES:                                                                                                                                                                       

DETAILS FOR OPEN SHOW APPLICATION

Date of Show:                                                 Venue:                                                                                                            
Will a catalogue & award sheet be available for this show                                                                                            
Name of Judges:                                                                                                                                                                     
Will there be sections for CHAMPION:      INTERMEDIATE:      NOVICE:      BEGINNER:      JUNIOR:          
Number of budgerigars ENTERED excluding sales at previous show:                                                                       
Number of budgerigars BENCHED excluding sales at previous show:                                                                       
Patronage awarded at previous show:                                                                                                                                

***I have read the LCNWBS Patronage rules and understand that if the conditions of any allocated patronage are not adhered to, or any alterations are made without prior consent of the committee the patronage may be withdrawn.***

SIGNED ON BEHALF OF THE ABOVE SOCIETY:...............................................................................