Application Form

SOCIETY MEMBERSHIP

Application FormPlease print the form below, complete (*optional) and send, with your cheque, to: Dr. A. Allnutt, Hon. Membership Secretary, ?Woodside?, Old Perry Street, Chislehurst, BR7 6PP-------------------------------------------------INFORMATION FOR THE SOCIETY RECORDS, PLEASE WRITE CLEARLY.Mr/Mrs/Miss/Ms. ............................First Name(s)???????????????......................................................??..??..Surname ???????????????????????????...............????..Address ???????????????????????.???????...............?..????????????????????????????????..............???..Postcode ??????....?. *Telephone....................................................... *Email ??????????.....?@?????........??????????????...?Amount enclosed £ ?????...........?Please make your cheque payable to "Bromley Borough Local History Society".Please note that our membership records are kept on computer for administration purposes only.I/We apply to join the Bromley Borough Local History Society and enclose my/our subscription for the year ending 31st December 2009.

To print a copy of the blank form, click below:

Signed ??????????????? Date ??/??/??.....

GIFT AID DECLARATION (Optional, but if you are a tax payer it means the Society can reclaim the equivalent tax paid at no cost to yourself.)I am a UK taxpayer and would like Bromley Borough Local History Society to reclaim tax on this subscription and any further payment to the Society. I pay an equivalent amount of income tax or capital gains tax at least equal to the amount the Society will reclaim. I will advise you of any change of address or if I cease to qualify for Gift Aid.Signed ??????????????? Date ??/??/??.....