Membership Application – City Livery Club

Title

Other formal Title(s), if applicable

First Name *

Middle Name

Last Name *

State-given Orders, Decorations, and Medals

e.g. GBE, BEM, TD

Other Orders

e.g. Order of St John, International Orders

Appointments and Elected Offices

e.g. JP, KC, MP

Preferred name

Date of Birth *

Street Address 1 *

Street Address 2

Town/City *

Postcode *

Country *

County

Email *

This email address will be used by the Club to send you information about the Club activities.

Phone (Mobile) *

Phone (Home)

Please see a full list of qualifying Liveries/Guilds/Clubs here: https://www.cityliveryclub.com/apply/

Member of qualifying organisation(s) *

Read more about our special interest Sections here: https://www.cityliveryclub.com/club/sections/

Which City Livery Club Sections would you be interested in joining?

What other interests or hobbies do you have?

Qualifications

How did you hear about the Club?

Name of Proposer *

Please type "Require assistance" if not known

Proposer's Email *

i.e. name@email.com

Preferred Newsletter Format *

Digital

Printed

Direct Debit Mandate *

I understand that my application will not be considered until I submit the online Direct Debit Mandate

Application for Membership