Application form

APPLICATION FOR MEMBERSHIP

 

PLEASE USE BLOCK CAPITALS TO FILL IN THIS FORM, thank you!

 

Name

 

(1)                                                                                                                                     

 

(2)                                                                                                                                     

 

Address:

 

 

Postcode                                   Tel:                                       

 

E-mail address                                                                                                              

 

I/we support  the campaign to improve the Ashford to Hastings rail link and apply to become a member/s of “MLAG”

 

I/we enclose the sum of (please tick the appropriate box and fill in any additional donation amount, followed by the total amount):

 

Payment:                                                                                                       

Annual membership fee (from 1 January 2018)

Member (1)              £  3.00

Member (2)              £  3.00                               (delete if not appropriate)

Donation                  £ 

 

Total                       _____

 

 

Signature                                                                           Date                                     

 

 

To update our membership records we would like to enter the details you  have given above on to a computer. We will not release this information to anyone outside MLAG. If you object to this information about you being held on computer, please tick here

 

When completed, please return, together with your remittance (£3 minimum, with cheques made payable to “MLAG”) to:

 

Mr David Bookless

MLAG Membership Secretary

3 Faraday House

RYE

East Sussex    TN31 7EW