SWPCA MEMBERSHIP FORM - 2009

Please complete and return with the appropriate remittance to -The SWPCA Secretary -
Miss J McKnight, 7a Hospitland Drive, Lanark.  ML11 7EJ  Any Subscriptions not renewed before 31 March will be subject to a rejoining fee of £5.00.  This does not apply to new members joining for the first time.

 Email Address _______________________________________
Adult Single £ 12 
 Adult Double(2 at same address) £15
Junior (under 18 years) £ 6
Family (2 adults + children) £18
SWPCA Members Badge @ £2.00 each

(cheques should be made payable to SWPCA) Total amount enclosed ......................................................

SECTION 1.

To renew your SWPCA Membership without change, please tick box
 

Print your name and address here..............................................................................................................................

SECTION 2.
NEW MEMBER (S) - or any changes current member (s) wish to make to their Membership.
i.e. name, address, postcode, telephone no. to take out or add names to family, double memberships?

Name (s) and Address of Member (s) (please state Mr, Mrs, Miss, Ms or other Title)

Adult (s) .....................................................................................................................................................................

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Post Code...................................................Telephone Number.............................................................................

SECTION 3

JUNIOR (S) (under18 years)
Name (s), Address (address if different from Section 2), and date (s) of birth.

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Post Code.......................................................Telephone Number................................................................................

Please sign here............................................................................................................................................

 

I do not wish to have my name and address disclosed on any SWPCA Publication.   

 
 
 
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