Kent Branch of the Jane Austen Society
Membership Application
PLEASE COMPLETE IN BLOCK CAPITALS
Name:
.................................................................................................
(please state Mr/Mrs/Miss/Ms etc)
Address:
.................................................................................................
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.................................................................................................
.................................................................................................
Postcode:
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Telephone
........................................ Mobile:............................................
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Individual membership £12 (or £11 if you are willing to
receive information via e-mail)
Household membership
£18 (or £17 for e-mail option)
(please tick as applicable)
I wish to pay by cheque / bankers order (please delete as appropriate)
Signature:
....................................................... Date: ............................
Forms should be sent to the Membership Secretary, including a cheque made payable to The Jane Austen Society (Kent Branch)
or a completed Bankers Order form. |
Membership Secretary: |
Elizabeth Earl |