Membership Form

I would like to join the Cumbria Industrial History Society

Name ………………………………………………………………………………………………………………………………………………………………………………….
Address ………………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………………
Postcode ………………………………………………………..
Phone Number ………………………………………………………………………………
E-mail Address ……………………………………………………………………………..
Signed …………………………………………………………….    Date ……………………………….

Annual subscription rates from 2013 are Single £10.00 or Joint £15.00 (more than one person at the same address). The subscription runs from the date that you join.

We would encourage you to pay by direct debit by completing the form below. It saves time and costs for both you and the CIHS. Alternatively please make out a cheque payable to CIHS.

I wish to have this and any other payment made by me to be treated as Gift Aid. I am a UK taxpayer. Please tick here [   ]

Please return to: Robin Yates, CIHS Membership Secretary, Glenrae, Brigsteer Road, Kendal, Cumbria, LA9 5DY,

or contact robin@phonecoop.coop for more information.
We look forward to hearing from you.

BANKERS ORDER
To ………………………………………..Bank PLC
Address ……………………………………………………………………………………………………………………………..
Please pay to NatWest PLC, 113 Dalton Road, Barrow-in-Furness (01-00-61) for the credit of CUMBRIA INDUSTRIAL HISTORY SOCIETY, Account No. 51640066, the sum of:
£ ……………….(figures)……………………………………..(words)
Commencing NOW and on the same day each year until you receive further notice from me/us in writing and debit my/our account accordingly.
Account to be debited ……………………………………….. Number………………….. Signature ……………………………….