MEMBERSHIP APPLICATION FORM
Please return the form to Fairford History Society,
Community Centre,
Mr/Mrs/Miss/Ms (Ring which applicable)
Name(s) (IN BLOCKCAPITALS PLEASE)
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I/We wish to
join/remain a member of Fairford History Society. I/We have filled in the
standing order form/or enclose £5 each
for
. member/s. (Please delete as applicable)
Signature
.
Date
Fairford History Society
BANKERS ORDER
To
Bank
Branch
Sort Code
Account
No.
Address
On September 1st and yearly
thereafter please pay Lloyds Bank, sort code 30-92-06
A/C
Fairford History Society No 2170130. the sum of
. This order to remain in
force until cancelled by me in writing.
Name of account
holder
.
Signature
Date