We would like to make sure that our records are up-to-date, and would therefore be grateful if you could complete the following:
Token:    Get a token
Name:
Address:
Postcode:
Home number:
Mobile number:
E-mail address:
I would prefer to be contacted by:
Home number
Mobile number
E-mail
Data Protection Act
"I give permission for the Committee to pass on my contact details (e-mail or telephone numbers only) to a Society Sub-Committee when they are arranging an event. I understand that this information will not be passed on to third parties or used for anything other than Society business."
I agree with this statement
I do not agree with this statement
Membership
I would like to begin or renew my membership (annual fee: full £15.00 / student £7.50)
I would not like to begin or renew my membership
I have already paid my membership fee of £15.00 / £7.50 and am therefore a current member
I am an active student, and am therefore entitled to the reduced fee. If this box is ticked, give date of birth:  

Friends of the Society
I would like to become a Friend of the Society (annual fee £20.00)
The 500 Club
I would like to become a member of The 500 Club, and choose to pay ...
... annually at £20.00
... quarterly at £5.00
Amount payable: £
I will be sending a cheque for the above amount, and request payment details.
I will not be sending a cheque as arrangements have been made to pay by direct debit or standing order
I will not be sending a cheque because:  

This form will be sent to the Membership Secretary, and copied to your specified e-mail address.
If you do not receive e-mail verification, please contact the Membership Secretary using the link on the Committee page.