Membership Application Form
(Membership runs annually from 1 October to 30 September and is renewable on 1 October each year. Regardless of application date you will receive all published material for the year).
Membership Required (please circle) Single: £16.00 Dual: £18.00 Overseas: £24.00
Title (Mr/Mrs/Miss etc) ................. Surname ...................................................... Forename .........................................................
Known As (eg. "Bill" for "William") .......................................................
Dual Membership Information (if applicable) :-
Title (Mr/Mrs/Miss etc) ................. Surname ...................................................... Forename ........................................................
Known As .........................................................
Address ...................................................................................................................................................................................................
.................................................... Post Code ............................ Country (if not U.K.) ...........................................
Telephone Number ...................................................... Email Address ............................................................
** I agree / do not agree that my Address and / or Phone Number and / or Email Address may be disclosed to fellow members. I understand that the above details will be stored on a Computer Database for the sole purpose of the Society Mailing List.
** Please delete as necessary
Signed ................................................................................ Date ............................................
Please make cheques payable to "The Carnival Glass Society". Overseas applicants should note that we can only accept cheques drawn in Sterling on a U.K. Bank.
Introduced by ..................................................................................... (if applicable)
Administration Only
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M/Ship No. |
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Post to: The Carnival Glass Society, Membership Secretary, PO Box 14, Hayes, Middlesex, UB3 5NU, England