THE VALLEY CONSERVATION SOCIETY MEMBERSHIP APPLICATION 2017

Membership of the Society is £2 per year, associate membership for young people aged 14 to 18 is just 50p. To join, print off this application form and send it together with a cheque made payable to

Valley Conservation Society to the Membership Secretary at: 3 The Manor, Hayle Place, Maidstone, ME15 6DW

Please sign up all members of your household!

1) …………………………………….. Full/Associate (under 18s)

2) …………………………………….. Full/Associate

3) …………………………………….. Full/Associate Doing nothing is not an option

4) …………………………………….. Full/Associate

Address: ……………………………………………………………………

…………………………………………………………………………………….

(Please include Post Code)……………………………………………………………

Phone: ………………………… E-mail: …………………………………..

Signature (s) ………………………………………………………………..

…………………………………………………………………………………………..

I enclose a cheque for £… ……….. (Donations welcome) I would be able to assist with (please tick)

Leaflet delivery

Work Parties

Other Voluntary Tasks

Receive News via emails : Yes / No (Please circle) Office use only:

Issued: Donation: Website Application

STANDING ORDER MANDATE

To the Manager

Your bank or building society name here: ………………………………………………………………………………

The Bank address here: ………………………………………………………………………………………………………..

Please pay: Lloyds Bank, 18 Week Street, Maidstone, Kent  ME14 1RW

For the credit of Valley Conservation Society

Sort Code: 30-95-37

Account Number: 02166853

The sum of £ ……………………………

Commencing on the first day of January 20…….. and every year thereafter on the same date until further notice, and

debit my account accordingly.

Your account name: …………………………………………………VCS Ref No: …………………………………..

Your bank’s sort code: …….…………………… Your account number ……………………………………………

Signature: ………………………………………………………….. Date: ………………………………………………_

Membership is £2 per year (or 50p for young people aged 14 to 18).
Please fill out this form and we will contact you.