Friends of Real Lancashire

Membership Application/Renewal form

I/we wish to become member/s of the Friends of Real Lancashire []
I/we wish to renew my/our membership for the current year      []

UK       - Single person £6 [] Family £8  [] Corporate £7 []
Overseas - Single person £8 [] Family £10 [] Corporate £9 []

We have kept subscriptions as low as possible to avoid
excluding people on low incomes and small businesses.
Increased payments are always welcome.

I/we enclose an annual membership fee of £_____

Title_____Name_________________________________

Address________________________________________

_______________________________________________

_______________________________________________

___________________________Postal Code_________

Telephone Number_______________________________

E-mail Address_________________________________

If you object to your name being circulated
to other members ONLY please tick here     []
Names will NOT be circulated to ANY other organisation

We can only accept payment from overseas members as an
International Money Order or a cheque drawn on a London bank made
out in Sterling. Cheques should be payable to 'FOR Lancashire'.

Total payment enclosed £_____

Membership No__________(for office use)

Please send this completed form with your payment to:-

                Mrs Janet Brooks
		Cartmel Cottage
		4 Westholme
		Fernleigh Road
		Grange-over-Sands
		Lancashire
		LA11 7HN