THE HARWICH SOCIETY : Application for membership then complete the boxes in ink and post to:

Aileen Farnell

Membership Secretary

The Harwich Society

Foresters

5 Church St

Harwich

Essex

CO12 3DR

England

I wish to become a member of the Harwich Society.


DETAILS ( Please complete in ink after printing )

SURNAME:

 

FIRST NAME:

 

ADDRESS:

 

 

 

TOWN:

 

COUNTY:

 

POSTCODE:

 

TELEPHONE:

 

TYPE OF MEMBERSHIP

FEE

TICK

Adult

£ 5.00

 

Family (including all children under 18)

£ 7.00

 

Senior citizen

£ 3.00

 

Junior member (under 18 or full-time student)

£ 3.00

 

Member residing outside UK

£10.00

 

Non-profit making group

£10.00

 

Commercial group

£15.00

 

I enclose a cheque (payable to Harwich Society ) to the amount of £..................