Your details.

Name

Address

Post Code

Tel. Number

E-Mail

Age (Junior/Student categories only)

Category Choose from drop down list Single Membership (one Adult) £12.00 Joint Membership (2 adults at same address) £16.00 Full-time Student (24years old and under) £7.00 Junior (18 years old and Under) £4.00 Corporate Membership £50.00 Life Membership £200.00

I/we would like to include a Donation of

Please find a cheque enclosed for

*I wish to pay by standing order - Yes No

Please print this form and post to:-

Diana Dyer, The Cedars
3 Osmay Road,Swanage
Dorset
BH19 2JQ

For enquiries 01929 421402 and email Diana:- richarddiana@tiscali.co.uk