Quondam annual membership form

Quondam Subscription Renewal (£10 due per year)

Personal details

Title: …………. Surname:……………………………......First name: .....……………………………

Surname at School (if different) ……………………………………Years at School: ……….. to………….

Contact details (Please give the ones you are happy for Quondam to use)

Postal address:…………………………………………………………………………………………………………

……………………………………………………………………………………………………………….....

Phone number: …………………………………Email:……………………………………………………

Account name: Quondam Benevolent Society

Sort code: 20 – 90 - 69  Account number: 9075 2010  Description: ‘Your Name-Subs’
Either
I have set up a new Standing Order The first payment date is ……../………/………*

OR
I pay my subscription by Standing Order. The annual payment date is ………/………*

Arrears Payment

I have paid by cheque* / I have made a BACS payment * for £…………….

You can pay-in a cheque at any branch of Barclays Bank or you can post a cheque to Barclays Bank PLC, Leicester, Leicestershire LE87 2BB, UK with a cover letter stating the account paying-in details above. 

If you pay by cheque, please email Margaret (lockleymeg @ gmail.com) to confirm the amount and date paid .

Thank you, Margaret, Membership Secretary

Newsletter

I should like to receive my newsletter by email* or post*

(*please delete as necessary)

Signature: …………………………………………………………….. Date: ………/…….../…………

Please copy and paste this form into an email, fill-in details, then email to lockleymeg @ gmail.com