Associate Membership Application - Scottish Thistles Masters Hockey Club

Username *
This is the email address you first entered and cannot be changed.
Email *
This can be changed but your Username remains as the first email address entered.
Password *
Password
Membership Level *
Associate
Player ID
Leave blank - we shall add this (format XX99). Use this prefixed with TOPUP with no spaces (as in "TOPUPXX99") as the bank reference in payments you make to us.
Shirt Number
Leave blank. This will be added where you have a shirt number allocated.

First Name known as *
Name you want us to use socially and in emails (e.g. Mike)
Formal First Name *
The same as Known As or your official first name (e.g. Michael).
Last Name *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Mobile Phone *
Example: +44 7012 123123. If no mobile use your home number.
Contact me? *
Yes
No
We need YES to contact you about playing events and Thistles participation (you will not be indundated). NO will limit contact to formal matters only (e.g. AGM).

Date of Birth *
Select from the calendar or enter eight digits dd/mm/yyyy
Playing Section *
Associate you membership with one fo these two playing secions: Ladies/Female or Men/Male. (Not Specified means receiving double information
Other
Other information if required