Membership Application Form
Please print this form and fill it in (BLOCK letters only please).
I/We apply for Individual / Family / Corporate (delete as applicable) membership of the Reigate Society.
Name(s) - with Mr Mrs Miss Ms etc - or Company Name:
Address (with postcode please):
Please complete one of these two statements and delete the other:
I enclose a cheque for £............. made payable
to The Reigate Society
I have sent a completed Bankers Order Form for £............. directly to my bank.
If applicable, date of annual payment on Bankers Order Form:
Name of person filling in form - in block letters please:
Date of filling in form:
Please send the completed form (with cheque if applicable) to the Hon Registrar of the Reigate Society at the address provided below:
Mr Robert Bogin,
64 Church St,
Shortly afterwards you will receive a joining pack by post.