Officially Sanctioned 1993

OFFICIAL PATRICK SWAYZE INTERNATIONAL FAN CLUB

Name....................................................... Address.................................................... .................................................................. .................................................................. Telephone................................................. Do you have e-mail?................................ Date of Birth............................................. Occupation................................................

Send us a photo of yourself just for fun!

Hobbies............................................................................................................................
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What I Like......................................................................................................................

What I Donīt Like!!.........................................................................................................

Where Did You First Hear About Us?............................................................................


Please tick:

	(a) I would like to receive newsflashes by post, and I enclose 4 IRCīs (International Reply-paid Coupons available from your Post Office), plus 4 self-addressed envelopes.
	(b) I do not wish to receive newsflashes by post.

Members who also have internet access can check for newsflashes on our website.

I hereby declare that I would like to become a member of the
Official Patrick Swayze International Fan Club.

___________________________	___________________________
Signature	Date

Club Address: P.O. Box 12980, DALKEITH, Midlothian, Scotland, EH22 4YJ, United Kingdom, Europe.

Official Website: http://www.patrickswayze.net/index.htm

In accordance with the Data Protection Act 1998, we hereby inform all members that their names and addresses are kept on computer for the clubīs mailing labels only. This information will NOT be sold, or in any other way disclosed to any individual, group or company under any circumstances and is merely kept on computer to assist us in the smooth running of this club.