Grahame Greene Birthplace Trust

Application Form

I wish to become a Friend of the Trust
Please write clearly in BLOCK CAPITALS

Full name..............................................................................
Title.....................................
Address..................................................................................
...............................................................................................
...............................................................................................
...............................................................................................
Postcode...................................
Telephone..............................................................................
Fax/Email...............................................................................
Organisation (if any).........................................................................................................
I enclose a subscription for: 1 year/3 years £.........

Signed..................................................................................
Date.................................................................................

SUBSCRIPTION RATES The subscription year runs from June to May.

	1 yr	3 yrs.
UK	£8.00	£20
Rest of Europe	£11	£27
Elsewhere	£15	£40

Please send to
Graham Greene Birthplace Trust
Rhenigdale, Ivy House Lane,
Berkhamsted, Herts.
England HP4 2PP