THE IRVING SOCIETY

MEMBERSHIP APPLICATION/SUBSCRIPTION RENEWAL 2008/2009

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 £20.00     Double £34    First Knight only £14

Overseas: Full £24.00     First Knight only £18

(1) CHEQUE ENCLOSED made payable to The Irving Society (RECEIPT NOT/REQUIRED)
(2) TO PAY THROUGH ONLINE BANKING:  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 to Sylvia Starshine/The Irving Society, Highgate UK PO, London N6 4EJ.
     Phone (44) 845 722 3344. Please add £1.50 to cover charges and inform the Hon Treasurer of your receipt number.
     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 1st October each year.
Prospective members joining up to 3 months prior will have cover for the ensuing year.
I DO / DO NOT OBJECT TO THIS INFORMATION BEING USED BY A SIMILAR ORGANISATION.

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