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Elgar Society Membership Postal Application
Form
Please print this form and, having completed it, return it to :
Mr David Morris, (2 Marriott's Close, Haddenham, Bucks., HP17 8BT)
Name :
...............................................................................................................
Address : ...........................................................................................................
...........................................................................................................................
Postcode : ............................ Telephone Number : .............................................
e-mail address : .................................................................................................. |
| Name of Second Member (1)
: .......................................................................... |
I wish to belong to the following branch(es) of the Society (2)
:
..... Great Western
..... London |
..... Southern
..... Scottish |
..... North West
..... Thames Valley |
..... West Midlands
..... Yorkshire |
|
I enclose payment of (tick as appropriate, see note 3).
For details of how to pay, see note (4) :
Full Member :
2 Full Members at same address :
Student Member :
2 Student Members at same address :
1 FM and 1 SM at same address: |
(UK & Europe)
..... £30.00
..... £35.00
..... £15.00
..... £17.50
..... £20.00 |
(Worldwide)
..... £32.00
..... £37.00
..... £16.00
..... £18.50
..... £21.00 |
I wish to pay by Visa / Mastercard (delete as appropriate)
Card number : ....................................................................................................
Card security number : ........................................................................................
Expiry date : ....................... Name on card : ......................................................
Address associated with card (if different from above) : .......................................
...........................................................................................................................
Postcode : .......................................................................................................... |
| Signature :
.......................................................................................................... |
| Date :
................................................................................................................. |
Notes :
(1) - A second member living at the same address and sharing a copy of the journal can join at a reduced fee.
(2) - UK members may elect to belong to a maximum of two branches. Overseas members are automatically assigned to
the Overseas branch as their first choice and their names forwarded to Paul Adrian Rooke (one of the International
Co-ordinators).
(3) - As Student Members pay a reduced fee, and as the mix of Full and Student Members at the same address can
vary, care should be taken in selecting the correct category for payment.
(4) - Payment may be made by credit card (Visa or Mastercard) or by cheque made out in pounds sterling. Because of
the high bank charges on International Money Orders, the Society cannot accept payment in other currencies.
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