Application Form
To the Secretary of the Skelmersdale Horticultural Society
I, the undersigned, hereby make an application for one of the allotment gardens provided by the Council at Manfield, Ashurst, Skelmersdale WN8 6SU.
1. Name:………………………………………………………………………………….
2. Address: ..........................................................................................................................
.............................................……………… Post Code……………………………
E-mail address ………………………………………………………………………...
Telephone number …………………………………………………………………….
3. Whether holding any allotment garden or agricultural land and if so:
(a) From whom?…………………………………………………………………….
(b) Extent of land held:……………………………………………………………….
(c) Whether quitting the land, and if so, when?………………………………………
In the event of my application being granted, I agree, when requested by the Society, to sign an agreement for letting in accordance with the rules.
Signature:………………………………………………………
Date:……………………………………………………………
Return to:
Skelmersdale Horticultural Society
Plot Secretary
Mrs D Walker
60 Manfield
Ashurst
Skelmersdale
WN8 6SX
Word Doc Application form [40KB]