CHARLIE LANDSBOROUGH
                           Forever Friends
                      Fan Club Application Form

UK MEMBERSHIP 1 YEAR - £7.00.  OVERSEAS MEMBERSHIP 1 YEAR - £12.00.
              2 YEARS £12.00.                      2 YEARS  £22.00.

        I wish to apply for membership of the above Fan Club
                   PLEASE PRINT AND COMPLETE ALL
MR
MRS      Surname...................................................
MISS
MS       Forename..................................................

Address............................................................

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Phone No......................     Postcode........................

E-Mail.............................................................

Your old Ritz Fan Club No. (if you have one) ......................

Please pay by cheque or postal order
made payable to: Charlie Landsborough Fan Club.
                          All correspondence to:  Garry Cotton
                                                  Forever Friends
Signed.........................                   17 Trinity Close
                                                  Evesham
Date...........................                   Worcs. WR11 1JF