MEMBERSHIP APPLICATION
If you would like to become a member of Le Couvent, please take a few moments to leave provide us with some details for our membership register.  Please note that we do not currently operate a secure server, so if you prefer, you can apply for membership by telephone on 0115 941 0246, or we can call you back.  Membership for one year costs just £40, and allows you into Le Couvent on Friday and Saturdays after 10pm for just £2!
 
Your name:
Your address, including postcode:
Your telephone number:
Your email address:
Your occupation:
Credit card number*:
Name of cardholder:
Expiry date:
*or enter a telephone number where we can call you back for confirmation.