Application Form
NORTH STAFFS ROAD RUNNERS ASSOCIATION APPLICATION FOR MEMBERSHIP
The NSRRA is an Athletics Club affiliated to staff's AAA and UKA. Its aim and objectives are to encourage
and facilitate road running: and, secondly, to stimulate and foster participation and friendly competition
at a variety of levels in road running. Membership is open to all amateur athletics who have attained
the age of 18 years and who normally reside in or are members of athletics clubs in the
North Staffordshire and adjacent areas.
The Association caters for runners of widely differing abilities from first-class athletes to genteel joggers.
It organises its Group or League competitions on the basis of the demonstrated current ability of each
member and it is therefore necessary for new members to provide the six best results achieved in races
during the preceding 12 month. If you have not competed in 6 races in that period, you are nevertheless
welcome to join us immediately but we will not be able to place you in one of our Groups until you have
submitted six results. In all cases, the initial allocation is provisional and may be reviewed.
The details you are asked to supply below , together with your performance in races in our
programme, are stored in and processed by computer solely for the administration of the
Association's affairs. We could not cope with a membership of several hundreds without being
"computer -aided". We must therefore ask your permission to include this information in our
computer files but we do assure you it will be used only by the Association and only for its routine business.
If you want to join complete the form below, preferably in CAPITAL letters, and return it to Steve Locker,
7 Michigan Grove Trentham, Stoke-on-Trent, ST4 8UF. Full information on the Association's
current programme ect will then be sent to you as soon as possible.
__________________________________________________________________________________________
1) I wish to become a member of the NSRRA. I am an amateur according to UKA rules
I agree to abide by the Constitution and rules governing the Association.
I do not object to the Association holding my membership record in a computer provided that record is used
solely by and for the declared purposes of NSRRA.
2)BASIC DATA (a) FORENAME/ INITIALS+SURNAME: <give YOUR preferred form of name e.g. "Tom Jones"
rather than T Jones: it will appear on address labels results sheets, ect:there is a maximum of 10 +20
characters):
(a)________________________________________________________________________________________
(b) DATE OF BIRTH ______________________________________(c) SEX M [ ] F[ ]
(d) ADDRESS ( please give full details and INCLUDE THE POSTCODE)
__________________________________________________________________________________________
______________________________________________________(POSTCODE)_________________________
(e) TELEPHONE (Exchange and Number )_______________________________________________________
(f) CLUB (First Claim AC if any)________________________________________________________________
(g) (for Completion by the Association) NUMBER______________________GROUP____________________
(3) BEST SIX PERFORMANCES in races during the last 12 months:
1________________________________________________________
2________________________________________________________
3________________________________________________________
4________________________________________________________
5________________________________________________________
6________________________________________________________
(4) The CURRENT SUBSCRIPTIONS are £5.00 and that Sum (Payable to NSRRA)
MUST ACCOMPANY THIS APPLICATION with a Large (6x9) SAE:
Signature and Date ________________________________________________________________________