Esher District Local History Society

MEMBERSHIP APPLICATION FORM

I/We wish to join the Society and enclose a cheque for £10/16* made payable to Esher District Local History Society (Delete as applicable. No cash payments in post please)

Title:................ Name:..........................................................................................................(Capitals please)

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

................................................................................................................................... Post Code:...........................

Email:......................................................................................................................................................................

Phone:...............................................................................................................

Signed: ........................................................................................................... Date:.............................................

*A single person annual subscription of £10, or £16 for 2 people, will ensure delivery of 3 newsletters a year, access to all Society Meetings usually at least 10 a year (guests are most welcome for a £2 entry) and an outing further afield. As subscriptions are our main source of income, we welcome any donation, in addition to the above. Thank you very much.

Please post the above completed application form together with payment to our Membership Secretary:

Dr. Veronica King 22 Riverside Drive, Esher KT10 8PG

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