XL Club: Change of Details Form

First Name Other Initials Surname

District

Indicate changes as appropriate - complete 'Old' address in all cases

Address
Old New
Phone number (home)
  Old New
Phone number (work)
Old New
Phone number (mobile)
Old New
e-mail address
Old New
Additional e-mail
         
I am no longer playing
I now umpire - my CRB number is
Other (max 200 characters)
 

 

  
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