Application for membership of The Milestone Society 2002/2003

Please copy, paste print out and complete this form and post it to the Membership Secretary with your remittance.

Name: ..........................................................................................................................................

Address: ......................................................................................................................................

.....................................................................................................................................................

.....................................................................................................................................................

Postcode:  ...................................................

Tel. No: .....................................................

E-mail:  ........................................................................................................................................

I/We wish to join the Milestone Society and enclose the annual subscription of £10 (single) / £12 (couple at same address, receiving one copy of all mailings). Please delete as appropriate. Cheques should be made payable to The Milestone Society and sent, together with this form, to the Membership Secretary: Brian Barrow, Larkrise, Clavering, Essex CB11 4QT, UK.  All payments in UK Sterling.

Declaration.  I do not object to data relating to me being held on computer or paper file by The Milestone Society and I do not object to the information recorded in this form being disclosed to other members of The Milestone Society as part of the Membership services of the Society.

Signed: ................................................................................

Name:  ...............................................................................

Date:  .................................................................................

Form MSwesite01