Edward Thomas Fellowship
Membership Application Form
Name (and title)
Address
 
 
 
Postcode

Annual Membership

I enclose £10.00, individual, or £15.00, two adults at the same address (£14 for two adults at the same address paying by banker's order).

I enclose total £___________ cheque/postal order/international money order
payable to The Edward Thomas Fellowship

Banker's Order

Your membership will be renewed automatically each January until you instruct your bank to cease payments.
Please pay to Midland Bank plc, 74 High Street, Alton, Hampshire, GU34 1EZ, sort code 40-08-21 for the Edward Thomas Fellowship a/c no.11250205
the sum of £____ and debit my/our account.

The first payment to be made on 01/01/__ and subsequently on the same date annually thereafter unless cancelled.
Name of my bank
Address of my bank
 
 
 
Postcode
Current Account No.                  
Sortcode      
Signature Date

Print out and return this form, including remittance or completed Banker's Order, to:
Larry Skillman, Eastbrook, Morleys Road, Weald, Sevenoaks, Kent, TN14 6QX.
Please do not send the Banker's Order direct to your bank.