FoSCL Membership Application Form
 
[back to main FoSCL Membership Page]
 
Please complete the following form and mail it together with a cheque or postal order payable to FoSCL to:
 
FoSCL Membership Secretary
5 Dewhirst Road
Brighouse
West Yorkshire
HD6 4BA
ENGLAND
 

Ordinary Member                         £10     [ ]
Family Member                           £12.50  [ ]
Life Member                             £250    [ ]
Junior Member (under 18)                £3      [ ]
Corporate Member                        £40     [ ]
Or/and donation to the development fund £__________
Making a total payment of               £__________

Please write for information if you wish to pay by 
direct debit.

Name:____________________________________________________

Address:_________________________________________________

_________________________________________________________

_________________________________________________________

Postcode:__________ Tel No:______________________________

Email:___________________________________________________

Are you interested in volunteering with us?:_____________

Date of Application:_____________________________________

.........................................................


We keep the membership records on computer file.  
If you object to your details being stored in this way, 
please let us know.