NORTHAMPTON TOWN F.C.
SUPPORTORS

SIXFIELDS TRAVEL CLUB

Membership For 2011/2012 season is FREE for all N.T.F.C
Supporters

Football Supporters Federation Insurance Cover is Optional, which
covers you for Late Match Cancellation coach fares and Personal
Accident. The cost of Insurance per season is £12.00 per person

Membership Form 2011/2012

     Name……………………………………………………………………

     Address…………………………………………………………………

     Post Code………………………………………………………..

     Tel No……………………………………………………………

     Mobile No ....................................................................................

     Date Of Birth…………………………………….

     e-mail Address ..............................................................................

     Membership No. if Known……………………….

     Insurance Optional £12.00 -  Yes Please : ...... or No Thank You : ......

Please tick Yes or No to take up the Insurance if Yes Please send
Cheque for £12.00 made payable to Sixfields Travel Club, and send to
Mrs Janis Ward Membership Secretary; 95, Bridgewater Drive, Weston Favell, Northampton. NN3 3AF

Your new membership card will be sent out upon receipt of payment.

Members of the Football Supporters Federation

PRINT FORM AND RETURN TO THE ABOVE ADDRESS
ENCLOSE A CHEQUE IF YOU REQUIRE INSURANCE