WESTERN HEIGHTS PRESERVATION SOCIETY

APPLICATION FOR ASSOCIATE MEMBERSHIP

Mr/Mrs/Miss/Ms. First Name: ………………………Surname: ……………………………….………..

Address:……………………………………………………………….…….Town: ……………..………

County: ……………………………….Postcode:……………….Phone (H): …………….……...………

E-mail: ……………………………………………………………..Phone (M) :…………………………

Is there any part of Western Heights that interests you particularly?

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

Would you be interested in becoming actively involved with (please circle):
Fund raising     Clearance work     Research     Publicity

Please send this completed form, with annual subscription of £5 to:
Hon. Secretary, PO Box 366, Deal, CT14 9XY.

I wish to pay future subscriptions by Standing Order and have sent the completed Mandate to my bank.
YES/NO