Please print this document, complete and return to Membership Secretary, Community Centre, Garfield Road, Addlestone, Surrey, KT15 2NJ
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| Name: |
.................................................................................................. |
| Address: |
.................................................................................................. |
| |
.................................................................................................. |
| |
...........................................................Post Code......................... |
| Phone no: |
................................................................... |
Annual Membership:
|
..................................................................................................
(£3.50 individual / £5.500 couples, same address) |
| Life Membership: |
..................................................................................................
(£35.00 individual / £55.00 couples, same address) |
| Joining Fee: |
£1.50 (also a late renewal fee if annual membership is renewed after May 31st.) |
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If renewing membership please complete the following: |
| Membership Number: |
................................................................... |
| Please list Section Membership, if applicable: |
................................................................... |
| Note: Do not include section membership subscriptions on this form. |
| If your membership has lapsed please add: |
| Address last notified: |
................................................................................................ |
| ...................................................................................................................................... |
| Previous Year of Membership: |
.................................... |
| Membership Number: |
.................................... |
| Note: The late renewal fee of £1.50 is applicable. |
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| Total Sum enclosed: |
..................................................................................................
(please make payable to Addlestone Community Association) |
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Signature ........................................................ Date .................................
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Charity Registration number 304962 |
Addlestone Community Association