Last modified:16th January, 2004
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The Angela Thirkell Society

Application Form


Full name (Mr/Mrs/Miss/Title)..................................................................................

Tel:.......................................................

First name.............................................

Address (please print).................................................................................................

.......................................................................................................................................

Occupation or Retired....................................................................

Interests/hobbies..............................................................................

Annual subscription £10 per person, due 1st January, cheques payable to the Angela Thirkell Society by Cheque/Standing Order Cash.

Date..........................

Signature...........................................

Please make cheques payable to:
The Angela Thirkell Society and send to:
The Secretary,
Mrs P Aldred
54 Belmont Park
London SE13 5BN

Banker's Order

To.................................................................Bank

Address:.........................................................................................................

.......................................................................................................................

Please debit my account No..........................to pay Lloyds Bank, Caterham Branch, 21 Station Road, Caterham, Surrey CR3 6YT Sort Code 30-91-72, for the credit of The Angela Thirkell Society Account No.0639437 the sum of £10 now and next on 1st January annually until further notice.

Signed: ..............................

Dated:................................