PRIDDY'S HARD, GOSPORT, HAMPSHIRE PO12 4LE

t: 023 9250 5600 f: 023 9250 5605 e: info@explosion.org.uk

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FREEPOST (SCE13122)

GOSPORT, HAMPSHIRE

PO12 4LE

FRIENDS OF EXPLOSION!

APPLICATION FORM

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Joint Membership: second name

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Explosion! Volunteer FREE (A Volunteer Application Form will follow)

Adult Single £15 Adult Joint £28

Family £33 (up to 2 adults and all children at the same address)

Please return to the above address with payment of the required amount. Cheques should be payable to “Gosport Borough Council”.