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Lincolnshire’s Lancaster Association

Membership Application Form

Enrolment and first year membership fee is £8-00 which should be forwarded with this form to the Membership Secretary at the address shown. Overseas members are £15-00 (Newsletters by Airmail)

Lincolnshire’s Lancaster Association

PO Box 474, Lincoln, UK, LN5 9ES

Subscriptions and any donations made payable to “Lincolnshire’s Lancaster Association Ltd”

Contact Phone Number: _____________________________________

Name:

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Address:

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Town/City:

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Country:

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Post Code:

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E Mail:

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Overseas Members Please Pay By Credit Card or in Pounds Sterling

Credit Card details:

Visa, Mastercard and Switch accepted

Card Number:

Valid from:

Expiry date:

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Last 3 numbers on the signature strip (rear of card):

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If Switch; Issue Number:

Full Name as on card:

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Billing address of the card if different to the address on the order:

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