SUBSCRIPTION APPLICATION FORM

I wish to apply for membership to the East Anglia Transport Museum Society Ltd. for the forthcoming year.

Title : ___   Name : ________________________

Address : ___________________________________________

               ___________________________________________

Postcode : ___________

Date of Birth: _________

I enclose remittance in respect of :

Ordinary Membership   (£15-00)        £_________

Junior (14-17) Membership (£8-00)   £_________

Members entitled to national
retirement pension             (£10-00)    £_________

Life Membership (£300-00)               £_________

TOTAL REMITTANCE :                  £_________

Signed : ___________________       Date : ___________

Please send your completed form to:

The Membership Secretary, 30 Essex Road, Longfield, Dartford, Kent.  DA3 7QL