MEMBERSHIP FORM
Please print out, complete and send with a stamped self-addressed envelope and payment made out to 'Southern Early Music Forum' to :
Tim Samuelson, SEMF Membership Secretary, 108 Howard Drive, Allington Park, Maidstone, ME16 0QB
| NAME | ............................................................ |
| TITLE | .................................... |
| ADDRESS | ............................................................ |
| ............................................................ | |
| ............................................................ | |
| ............................................................ | |
| ............................................................ | |
| POSTCODE | ................. |
| TELEPHONE | .................................... |
| FAX | .................................... |
| .................................................. | |
| INTERESTS | .................................................. |
| INTERESTS | .................................................. |
| INTERESTS | .................................................. |
| INTERESTS | .................................................. |
This information will be held on computer registered under the Data Protection Act and will be used to send you information about SEMF activities.
Do you want your details to appear in our printed membership lists? YES / NO
2010/2011 MEMBERSHIP FEES
Full Membership £9.50 Family Membership £5.00 Student Membership £5.00 Library Membership £5.00 Over-65 Membership £8.00
- Discount
- for new members or
for payment before 1 March
- Subscriptions of new members joining between 1 November and 1 March will run for the whole of the following membership year.
£1.00
I enclose £.............. and apply for membership of Southern Early Music Forum for the membership year ending at the end of February 2011.
Please sign and date below.
signed:...................................... dated: ......................
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