<%@ Page Language="C#" %> Membership Application Form
Membership Application Form

 Title:           

 

Surname:
  
First name:
  
Address:
  
Town:
  
County:
  
Post or Zip Code
  
Country:
  
Telephone:
(inc area code)		  
Mobile:
  
E-Mail:  
 

Type of Membership Required

Individual membership £20.00 p.a.
  
Student/young person (under 18) membership £15.00 p.a.
  
Family membership £25.00 p.a.
  
Corporate membership £30.00 p.a.
  
Amount due
 £

This form can be emailed to: cliveeaster100@yahoo.co.uk and secure payment made through PayPal.


Alternatively this form can be printed when completed and sent with cheque (payable to Church Monuments Society) to:

Dr Clive Easter BA BEd PhD
55 Bowden Park Road
Crownhill
Plymouth
PL6 5NG