STOVER CANAL SOCIETY

MEMBERSHIP APPLICATION FORM

(Print this page or Return to Homepage)

I/we would like to join the Stover Canal Society and enclose my/our subscription of £ ................

£5.00 for Individual Membership pa

£8.00 for Joint Membership pa (two people at one address)

Full names (Mr/Mrs/Miss/Ms/Dr/other..................................)         (block capitals please)

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

Full address ......................................................................................................

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

E-Mail Address...........................................

My/our particular interests in the Society are:.......................................................

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

Would you be prepared to become involved in a working party or assist in other way 

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

Ventiford House, Teigngrace, Newton Abbot  TQ12 6QN  and enclose a stamped self addressed envelope please

Cheques should be made payable to STOVER CANAL SOCIETY

Data Protection Act 1984. Society membership records may be held on a computer. Disclosure of individual members details will only be made to officers of the Society and other members and only in connection with the activities of the Society. If you object to your membership details being held on computer please tick the box. [    ]

Visitors since February 2005: