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• THE ASHCOMBE DORKINIAN ASSOCIATION
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I wish* / do not wish* to become a member of The Association
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• To A.D.A. Membership Secretary: Ted Hazelden, 23
Dunsdon Avenue, GUILDFORD, GU2 7NX,
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• or via
Mr James Robinson, Head of
Sixth Form
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Name/ Initials : ………………… Surname: …………………………………………….
• Address : …………………………………………………………………………..
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• Post Code: ………………………………..
• Years at
School From …………
to …………..
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Email Address: ………..……………………………………………………………….
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I wish*/do not wish*
my email address to be published in the Association Membership List
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• Telephone number
…………………………
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I am */ I am not*
applying for the ADA Bursary Award this year.
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•We expect you require a month or so to gather
your thoughts and then,
if you wish to apply, write your name on this form together with a letter of application which should then be handed to Mr Robinson,
probably by 7th May 2010. In principle we then consider the applications and invite a short list to attend for interview in the School in
June.
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• I wish
to be considered for the Ashcombe Dorkinian
2010 Bursary Award and will submit a letter and supporting information to Mr Robinson for forwarding to the Association Award Panel.
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• Name:
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