|
Corris Railway Society - Membership Application |
| Section
1: |
Your
details: |
| Your name: |
|
| * Your email
address: |
|
| * Confirm email
address: |
|
| * Subject: |
|
| Membership Number |
|
| Address |
|
| Post Code |
|
| Country |
|
If not UNITED KINGDOM then an extra £5.00 is required
to cover postage of newsletters etc.. |
| Telephone |
|
| FAX |
|
| Date of birth |
-
-
(dd-mm-yyyy) |
| Section
2: |
Conditions of Membership: |
| Members agree : |
1. To uphold the good name of the Society.
2. To accept decisions of the Annual General Meeting / Council / Management Committee duly made.
3. To use their best endeavours to further the aims of the Society.
4. To help preserve the amenities of the neighbourhood in which the Society is interested.
5. To respect the property of others.
6. If responsible, to indemnify the Society against claims for personal injury, of loss, or damage to property.
|
| Section
3: |
Membership Details: |
| Membership type: |
FULL
Membership (£15.00) |
|
|
JUNIOR/SENIOR Membership (£10.00) |
If under 18 or over 65 on 1st January
next |
|
FAMILY
Membership (£30.00) |
All residing at the same address |
|
LIFE
Membership (£300.00) |
|
| |
(1) Junior Membership: To qualify for Junior Membership the applicant must be under 18 years old on 1st January.
(2) Senior Membership: To qualify for Senior Membership the applicant must be over 65 years old on 1st January.
(3) This category of membership is available to all members of a family having the same permanent address.
General
a) Data Protection:
The Society is registered under the Data Protection Act. All Membership details are retained on computer and are used in connection with the business of the Society and not disclosed to ANY third party.
b) Overseas application requiring publications to be sent by air mail must add £5.00 to the annual subscription. |
| Section
4: |
Family Membership Details: |
| |
Surname :
First Name(s) :
Occupation :
Date Of Birth :
--
(dd-mm-yyyy) |
| |
Surname :
First Name(s) :
Occupation :
Date Of Birth :
--
(dd-mm-yyyy) |
| |
Surname :
First Name(s) :
Occupation :
Date Of Birth :
--
(dd-mm-yyyy) |
| |
Surname :
First Name(s) :
Occupation :
Date Of Birth :
--
(dd-mm-yyyy) |
| Section
5: |
Donations: |
| I wish to make a
donation to the Corris Railway Society |
General funds |
£
|
| Carriage Shed Appeal Fund |
£
|
F.O.C.R.M.
(Friends of the Corris Railway Museum) |
£
|
| Steam Locomotive Fund |
£
|
| I would like you to treat all
payments for Gift Aid |
(Please tick) |
You must be a current UK taxpayer. |
| I do NOT want to receive
Raffle Tickets to sell on behalf of the Society |
(Please tick)
|
Please tick this box if you DO NOT
wish to receive raffle tickets. |
| *
Please enter here information on any skills that you have that may be
useful to the Society or you
may enter a message if you wish: |
|
Please print this form, fill it in and send it with a cheque made payable to the Corris Railway Society to :-
Andrew Rawlins
3 Bridge Terrace, Llanbadarn, Aberystwyth, Dyfed, SY23 3RD
OR
Fill in the requested details on the WEB Page and send them through by clicking the
Send button below. This will ensure that your details are registered with the Society immediately.
It will also redirect you to our secure, authorised payment processor,
PayPal, where you may also pay by credit or debit card.
However, membership cannot begin until payment has been made to Andrew Rawlins. |
|
You must fill in
the fields marked with a * |