Membership application form ...... U.K. and International

U.K.

If you wish to join the Pudsey Civic Society, or be a patron, and live in the United Kingdom
please print out the blank form below, complete it and post it along with your subscription and a stamped addressed envelope to:-

Membership Secretary, 
PO Box 146,
Leeds.
LS28 8WY

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Membership application form

Membership types and rates per annum please tick box where required

• [_].... UK Household membership:- £5
• [_].... Overseas Household membership:- £8
• [_].... Society/ Association:- £5
• [_].... Corporation or Firm:- £10
• [_].... Patrons:- £10

Name____________________________________________________________

Address_________________________________________________________
________________________________________________________________

Telephone No _______________________ Subscription total £_______

please make cheque payable to "Pudsey Civic Society"

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International

If you wish to join the Pudsey Civic Society, or be a patron, and live outside the United Kingdom.
Things become more complex when it comes to payment, there are various ways it can be accomplished.

If you can

1. pay by cheque in sterling
2. pay cash in sterling ( notes only)
3. contact us, to work out some other way.

then please print out the blank form above, complete it and post it along with your subscription and a stamped addressed envelope to:-

Membership Secretary, 
PO Box 146,
Leeds.
LS28 8WY