Membership Form

Please print this Form and return it to the address given below.

Annual subscription rates for this year (31/8/07 to 1/9/08) are as follows :-

Single - GBP7.
Family and two adults and any children under 18 living at same address - GBP10.
Life membership – 10 times the annual subscription.

If you would like to join us please fill in the form using BLOCK letters, print it out and send it to: Miss Jane Rutter, the Membership Secretary, Christchurch Local History Society, c/o Druitt Library, High Street, Christchurch, Dorset, BH23 1AW.

Name(s) : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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Address : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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Postcode _ _ _ _ _ _ _ _ _

Telephone no : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
E-mail : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Please make cheques payable to ‘Christchurch Local History Society’. Please also enclose a First Class stamp for the return of your membership card, a copy of the constitution and the latest Journal.

Data Protection Act 1998 – the names and addresses of members are held on computer. This information will be used only for purposes connected with the running of the Society and will not be passed on to any other person(s) or organisations. Please inform the Membership Secretary in writing if you do not wish your name and address to be stored in this way.

To print this Form, right-click on this window and select 'print'.