Colonel Stephens Society

MEMBERSHIP APPLICATION

Please use BLOCK CAPITALS for your name and address, and delete at * where appropriate

NAME: ………………………………………………………………………………………………………………

ADDRESS..................................................................................................................................................................

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

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

………………………………………………………………………………………………………………………..

POST CODE: …………………………

 

PHONE (optional)…………………………………E-MAIL (optional)……………………………………………….

 

The Society maintains a record of members and their names and addresses on computer to produce the

mailing labels for the society's journal and for the membership secretary to manage renewals. Details of

a member are only passed to another member with prior agreement.

I do/do not* agree to my details being included in any listing of members circulated with the society's journal.

I enclose a cheque for £7.00 (UK) l £12.00 (Overseas) l £9.00 (joint UK same address, one Colonel)* made payable to

The Colonel Stephens Society.

Signature ………………………………….                       Date…………………………………… 

Please return this form, with cheque, to:

DAVID POWELL (CSS MEM SEC),

GATEWAYS,

BLEDLOW ROAD,

SAUNDERTON,

PRINCES RISBOROUGH,

BUCKS.

HP27  9NG

 

Telephone: 01844 34337

david.powell@waitrose.com