The Orchid Society of Great Britain

APPLICATION FOR MEMBERSHIP

To: The Membership Secretary, Walter Lefley, 39 Hainault Road, Romford, Essex, RM5 3AA

I/We_____________________________________________________________________________________
Mr., Mrs., Miss, etc (Block letters please)
hereby apply for membership of the Orchid Society of Great Britain.

Address__________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

Post Code: _____________________________ Telephone No:________________________________________

Email: _________________________________ Fax/Other:___________________________________________

Would you like your name and address to be included in the Journal as a new member YES/NO *
*  Please delete that which does not apply.

Annual Subscription: Individual £16 Family £16 + £4 for each additional member at the same address Young Person £12 (Under 21) Overseas Members’ Supplement(to cover additional postage) Europe including Eire £4 Rest of the World £5
Between the 1^st June & 5^th November a special 2 year membership is available to new members Individual £24 Family £24 for lead member + £6 for each additional member at the same address Young Person £18 Overseas Postage is £6
TOTAL		£
Method of  Payment, in sterling please (Tick box below)	Details Please complete box applicable
	I enclose a cheque/PO for £ ………………... made payable to:  The Orchid Society of Great Britain.
	Please debit my Access/Mastercard or Visa Card No. __ __ __ __      __ __ __ __     __ __ __ __     __ __ __ __ Expiry date __ __ /__ __
	Please collect my subscription by Standing Order, see next page.
	Please treat my subscription money for this year and until further notice as Gift Aid. I confirm that I pay an amount of income tax and/or capital gains tax equal to the tax that the OSGB will reclaim on my subscription payment for the year.

Signature:________________________________________________ Date:__________________

The Orchid Society of Great Britain

STANDING ORDER INSTRUCTION

To: The Manager________________________________________________ Bank PLC

_____________________________________________________________ (Name and Address

_____________________________________________________________ of Members’ Bank)

_____________________________________________________________

Please pay to National Westminster Bank PLC, 
                    Sidcup Branch, 
                    Sort Code 60-19-19
for the credit of The Orchid Society of Great Britain, 
                    Account Number 33618968,

the sum of £………on receipt of this Order, and a further sum of £………………
on the 1st January 20……..
and annually thereafter until further notice, quoting the reference ………………..(please leave blank)

and charge my/our account accordingly.

This instruction cancels any previous order in favour of the beneficiary.

Name(s) of A/C Holder(s)_______________________________ A/C No ____________________________

Member’s name in full:______________________________________________________________________

Member’s address:________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Signature _________________________________________________ Date _________________________