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THE ANGLO-NORSE SOCIETY |
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IN LONDON |
Please print
and complete this form and then send to the address below.
I/We would like to join the Anglo
Norse Society and enclose the subscription
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Annual rates. |
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Members under 25 or over 60 |
£20 |
Family membership |
£ 35 |
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Members aged 26 to 59 |
£ 25 |
Corporate membership |
£100 |
Name: . . . . . . . . . .
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Address: . . . . . . . . .
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. . . . . . . . . . . . . . Postcode: . . . . . . . . . . . . . . . . . . . . .
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Telephone (home). . . . .
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Mobile: . . . . . . . . .
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Date of birth (if under
26 or over 60) . . . . . . . . . . . . . .
- This year and future payments by standing
order (form completed below)
- This year Payment by cheque for £ . . . . . .
. . Enclosed
Please
return to The Anglo-Norse Society, 25 Belgrave Square, London SW1X 8QD
PAYMENT
OF SUBSCRIPTION BY BANKERS ORDER
ANGLO-NORSE SOCIETY (Registered Charity No. 263933)
BANKER’S ORDER
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To |
__________________________________ |
Bank |
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Address |
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Sort Code |
________________________ |
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__________________________________ |
Account Number |
________________________ |
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__________________________________ |
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Please pay to Royal Bank
of Scotland, Sort Code 16-00-16,
for the credit of the
Anglo-Norse Society in London (Account no.10134544) the sum of £________
commencing on __________ and on the 1st of January in every subsequent
year until I give you further notice, debiting such payments to my account. PLEASE
CANCEL ALL PREVIOUS STANDING ORDERS/MANDATES IN FAVOUR OF THE ANGLO-NORSE
SOCIETY
Signature(s) ______________________________________
Please
print your name here:
______________________________________ Date: __________
Please send this form to The Anglo-Norse Society (NOT TO THE BANK) at
25 Belgrave Square, LONDON SW1X 8QD
If you pay tax in Britain please also complete and return the Gift Aid form.