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Brixton Society |
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Membership Application / Renewal |
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| Please complete or tick whichever boxes apply: | |||||
| NAME (S): | |||||
| ADDRESS: | |||||
| POSTCODE: | |||||
| TELEPHONE: | |||||
| E-MAIL: | |||||
| Our membership year runs from July to July. For anyone joining at any other time of the year, membership runs to the July of the next calendar year. | |||||
| I / we apply to become a member / members of the Brixton Society | |||||
| I / we wish to renew my / our membership of the Brixton Society | |||||
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My / our membership number is: (if known – renewals only) |
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| Type of membership: | Individual £5.00 | ||||
| Unwaged £2.00 | |||||
| Local Groups & Businesses £10.00 | |||||
| I / we enclose a cheque to cover | years’ membership @ | £ p.a.= | £ | ||
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plus donation |
£ | ||||
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total |
£ | ||||
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Cheques should be made payable to "The Brixton Society" Please send your form and cheque to: Brixton Society
Membership Secretary |
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