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Stratford upon Avon Canal Society

Membership Application Form
(please print this form and complete it)

  Name .........................................................................
  Address .........................................................................
    .........................................................................
    .........................................................................
    .........................................................................
  Post Code .........................................................................
       
  Junior (under 18 yrs) @ £2.50 ...............................
  Student @ £3.50 ...............................
  Single Adult @ £7.50 ...............................
  Joint Husband and Wife @ £9.50 ...............................
  Life, Single @ £80.00 ...............................
  Life, Joint @ £95.00 ...............................
       
  Donation (thank you)   ...............................
  TOTAL   ...............................

Membership runs from September

Please make cheques payable to The Stratford upon Avon Canal Society

Send to
Clive Henderson
The Bridge House
Church Lane
Lapworth
Solihull
B94 5NU

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