Membership Application

THE FULHAM SOCIETY

MEMBERSHIP APPLICATION FORM page 1

PRINT OFF THESE TWO PAGES AND SEND TO:

The Honorary Secretary, The Fulham Society, 1 Rosaville Road, London, SW6 7BN

Membership Application Form
Name
Address
Telephone
Signature
Date

Annual subscription £............... attached (cheques should be made payable to the Fulham Society)

If you wish to pay by Bankers Order, which greatly helps the Society, please fill in the form on the next page and return both sheets to the Honorary Secretary.

The Bankers Order will then be sent to your Bank.

If you would like to help in the work of the Society please indicate below
Sub-committee work	Recruitment	Social Events
Research	Attending/reporting local meetings	Other (please specify )

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page 2

Standing Order for payment of Subscriptions to The Fulham Society
To	Bank
Bank address
My Account no
Please pay Lloyds TSB plc, Fulham Branch, 417 North End Road, London SW6 1NS, (sort code 30 99 02) to the credit of The Fulham Society account no 0079051, my subscription of £.............. and continue the same on the 25th March annually until further notice
Name (block capitals)
Address
Signature
Date

This standing order mandate should be sent to Mrs Maya Donelan at 1 Rosaville Road, London SW6 7BN for processing.

It will then be forwarded to your bank.

Last modified: 16 Novemeber 2008