Membership Form

Membership Form

I wish to join/renew my membership with The Bromyard & District Local History Society and enclose the sum of £

Subscriptions: Individual Membership £12.00 Family Membership £18.00 Associate (Jnr) £9.00

Please make cheques payable to: Bromyard & District Local History Society

Name:
Address 1:
Address 2:
Address 3:
Address 4:
Address 5:
Post Code:
Telephone Number:
E-Mail Address:
Gift Aid Declaration*I wish the charity to treat all donations I have made since 6^th April 2000, and all donations I make from the date of this declaration until I notify you otherwise as Gift Aid:	*Note: At current rates of tax the Society will receive an additional £3.38 on an individual subscription of £12 and £5.07 on a family subscription.
Please put a X if a current UK tax payer
Please put a X if not a current UK tax payer
I wish to resign as a member – please remove my details from your records
Signed:
Date:

Please fill in this page on your computer, then print out the page, and return it with your remittance to:

BDLHS Membership Officer, Benedikte Ward, 5, Sherford Steet, Bromyard, Herefordshire, HR7 4DL

E-mail: Benedikte@digthat.co.uk

The society holds information about you on a central database & other records. (Response/application forms, correspondence or other dealings with us including purchases etc). We use your information for administrative purposes only and will not make this available to outside organizations. You have a right to ask for a copy of your information for which we charge a small fee (£10).