Membership Form

Mark Rand

Name

First Name

Last Name

Telephone number

Spouse / Partner - Name

First Name

Last Name

Spouse/ Partner - Email

Spouse / Partner - Telephone number

Address

please include post code

Please confirm payment method (£10 couple/family. £6 for individual)

Please include your name as reference when paying via bank transfer to Metro Bank: sort code 23-05-80 A/c 43858904 Please hand any cheques (payable to 'East Woodhay Society') or cash to Mark Rand @ Lostock, Church Lane, Woolton Hill, RG20 9XG.

Bank Transfer / Standing Order

Cheque / Cash

Any comments

Data Policy and GDPR

I / We agree for EWS to contact me / us

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