MEMBERSHIP FORM
THE ROBERT JONES AND AGNES HUNT ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST
OLD OSWESTRIANS' CLUB
I wish to become a member of the Old Oswestrians' Club and for information to be sent to me each year about Club meetings.
Name ........................................................................................................
Permanent Address :
Present Address:
Post Held :
Duration of employment at RJAH Orthopaedic Hospital, Oswestry:
Tel No:
email address:
Subscription: LIFE MEMBERSHIP £25.00
Cheques to be made payable to “The Old Oswestrians’ Club”
I enclose a cheque to the value of £25.00 British Sterling.
SIGNED ..
DATE .
Return to:
Mrs S Cank Postgraduate Office Institute of Orthopaedics Robert Jones & Agnes Hunt Orthopaedic & District Hospital NHS Trust Oswestry Shropshire SY10 7AG
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