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 and, if accepted,
agree to abide by the Rules of the Society in all respects.

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(June - November 2 year offer £24)  
Family £16 + £4 for each additional member
(June - November 2 year offer £24 + £6)		  
Young Person £12 (Under 12) (June - November 2 year offer £18)  
Overseas Members' Supplement £3 (to cover additional postage - £6 for 2 year offer)  

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 Member's 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 ……………………

Top of Form