THE MILESTONE SOCIETY

REGISTERED CHARITY NO. 1105688


Application for Membership



Title (Mr/Mrs/Miss/Ms) .................Name .............................................................................

Address ...................................................................................... ..........

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

...................................................................... ..Postcode.................... ...

Tel. No. .................... ............. ... E-mail ..................................................

I/We wish to apply for membership of the Milestone Society and enclose the annual subscription* of: -
£10 - Single member, receiving one copy of all mailings
£12 - Couple at same address, receiving one copy of all mailings
£15 - Group/Corporate member, receiving two copies of all mailings
£20 Overseas member, receiving one copy of all mailings
I also enclose a donation of..................... to the Milestone Society
Please delete as appropriate.

I/We do not object to data relating to me/us being held on computer or paper file by The Milestone Society and I/we do not object to the information given on this form being disclosed to other members of the Society as part of the Membership services of the Society.

I am a UK Taxpayer and I wish the Society to reclaim tax on this subscription under the Gift Aid Scheme YES/NO

Signed................................................................................... Date...................

How did you learn of the Society?.........................................................................................

Cheques should be made payable to 'The Milestone Society' and sent, together with this form, to the Membership Secretary: Brian Barrow, Larkrise, Clavering, Essex CB11 4QT.

* The subscription year begins on 1st June. Members joining in the middle of a year will receive all newsletters and other publications issued since 1st June (subject to availability).



received

number

acknowledged

11.04