I wish to apply for membership of the Wallace Wanderers.

Name: _______________________________________

Address: _______________________________________

Post Code: _______________

E-mail: ______________________________

Telephone: _______________________

Mobile: ________________________

Polo shirt size: S / M / L / XL / XXL (for FREE Wallace Wanderers polo shirt)

Post the completed form with a cheque for £35.00 payable to Wallace Wanderers to:

Wallace Wanderers
c/o Music Travel Ltd
Studio 1
Cloisters House
8 Battersea Park Rd
London 
SW8 4BG

We also strongly encourage membership of London Scottish Football Club