CSCM 2007/08 MEMBERSHIP APPLICATION FORM

Please take a moment to fill in your details.
Personal Details:
Name* :
Surname* :
Address (line 1) :
Address (line 2) :
Town :
Post Code :
Country* :
Date Of Birth* :
dd/mm/yyyy
CSCM Membership No. :
(Insert Old No. If Applicable)
Email* :
Telephone* :
Fax :
Mobile* :
I.D. Card No.* :
 (if resident of the Maltese Islands)
Agreement: * I have read and understood the terms and conditions and agree to abide by the constitution of the Chelsea Supporters Club - Malta.
* I would like to enrol as a member of:
CHELSEA SUPPORTERS CLUB - MALTA
Membership Type:

Please indicate the type of membership you require *:
Local¹ Adult Member :
Applicable Fee = Lm 5.00 (see below)
Local¹ Junior Member :
Applicable Fee = Lm 2.50 (see below)
Payment Terms:

NB: No payment is required at this stage.
Following your application you will be contacted by the membership secretary about payment procedures. This will usually be in the form of a cheque or postal order to the address indicated below.
How did you hear about us:(*)
InternetReferralWord of Mouth
Printed MediaAdvertisingOther...
Notes:
All fields marked (*) are required.¹ Applicants residing in Malta or the Maltese Islands. ² Applicants residing outside of the Maltese Islands.
Apart from this online application for you may also download a Membership Application Form for 2007 - 2008 in Microsoft Word format by clicking here.

All correspondance regarding membership to the Chelsea Supporters Club - Malta should be addressed to the following:

Chelsea Supporters Club - Malta
c/o 2, Doris Flats,
Msierah Street,
San Gwann,
SGN08,
MALTA

For other enquiries please click here.

If you would like to apply for a Full or Affilliate Membership to Chelsea FC Football Club, please click here.
NB: Information collected from this application will only be used in conjunction with the CSCM database. This data will NOT be sold to nor given in exchange/gratis to third parties.
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© 2007 Chelsea Supporters Club - Malta®
Last update: Tuesday, April 17, 2007
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