Please print this document, complete and return to Membership Secretary, Community Centre, Garfield Road, Addlestone, Surrey, KT15 2NJ
|
| Name: |
.................................................................................................. |
| Address: |
.................................................................................................. |
| |
.................................................................................................. |
| |
...........................................................Post Code......................... |
| Phone no: |
................................................................... |
Annual Membership:
|
..................................................................................................
(£3.00 individual / £5.00 couples, same address) |
| Life Membership: |
..................................................................................................
(£30.00 individual / £50.00 couples, same address) |
| Joining Fee: |
£1.50 (also a late renewal fee if annual membership is renewed after May 31st.) |
|
| Total Sum enclosed: |
..................................................................................................
(please make payable to Addlestone Community Association) |
|
Signature ........................................................ Date .................................
|
Charity Registration number 304962 |