Application Form For Herb Society Membership

Please print and complete the form below

Herb Soceity logo

 

| Home | About Us | Join Us | News & Events | Education | Members Area |Contact

 

 

I would like to be a Member of the Herb Society :

Please tick Category Details Fee UK£
 

Full Member

 

Joint Member

UK and Channel Islands

* or £25 if paying by direct debit

2 members from one UK/Channel Islands household

27.00*

 

37.00

  Senior Citizen UK and Channel Islands 24.50
  Student Full time student and whose course of studies is due to be completed by __________ 24.50
  Overseas Based outside the UK and Channel Islands 40.00
  Family 2 adults and up to two children 42.00

 

Title ___________________________

Name __________________________

Address ________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________


Post Code _____________Landline _________________Mobile____________________


Email __________________________________________________________________

 

PAYMENT CAN BE MADE BY CHEQUE, CREDIT OR DEBIT CARD:

Cheque

I enclose my subscription of £___________

I wish to pay by Credit/Debit Card (Visa/Mastercard)-please delete as necessary

Please debit the sum of £ __________ from my credit/debit card

Name on card ______________________________________

Card No. __________________________________________

Valid from: ________________Expiry date ________________

Security code (last 3 digits of number on reverse)____________

 

Signature ______________________________ Date _______


Where did you hear about the Herb Society?

__________________________________________________________________

Please return with payment to:

The Herb Society, Sulgrave Manor, PO Box 946, Northampton NN3 0BN

Data Protection Act 1998:  Personal data collected on this form will only be used by the Herb Society and will not be disclosed to any external sources without your express written consent.


| Home | About us | News | Journal | Diary | Groups | Forum | Articles | Education | Links |