THE IRVING SOCIETY

MEMBERSHIP APPLICATION/SUBSCRIPTION RENEWAL 2010-11

PLEASE PRINT

SURNAME:...................................................TITLE & FIRST NAME................……………..

ADDRESS:...............................................................................................................................

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

POST CODE:...............................................TEL NO:………...............……………………...

E-MAIL ......................................................... MOBILE PHONE NO:.......................................


SIGNATURE...............................................................................................................................

I wish to apply under the following rates: (delete not required)

UK:          Full £25.00     Double £40    First Knight only £17

Overseas: Full £30.00     First Knight only £22

(1) CHEQUE ENCLOSED made payable to The Irving Society (RECEIPT NOT/REQUIRED)
(2) TO PAY THROUGH ONLINE BANKING:  The Irving Society, Lloyds TSB,  Harbour Island Branch. 
     Sort Code 30-13-54.   A/c No. 05238333.
(3) TO PAY THROUGH PAYPAL: treasurer@theirvingsociety.org.uk.  Please add £1.50 to cover charges.
(4) TO PAY THROUGH MONEYGRAM: send Customer Copy to Sylvia Starshine at the address below.
     To locate your nearest Moneygram agency visit www.moneygram.com

I wish to apply for / to renew / membership of THE IRVING SOCIETY.
I agree to abide by the Rules and Constitution laid down by The Committee.
I understand that the subscription becomes due on 1 October each year.
Prospective members joining up to 3 months prior will have cover for the ensuing year.

PLEASE SEND YOUR SUBSCRIPTION TO:

Sylvia Starshine
Honorary Treasurer
The Irving Society
Flat 7, 23 Stanhope Rd
London N6 5AW
UK

treasurer@theirvingsociety.org.uk