South West Herts Archaeological & Historical Society
Application for Membership


Name(s): ___________________________________________________________

Address: ____________________________________________________________

              _____________________________________________________________

              _____________________________________________________________

Postcode: ___________________________________________________________

Telephone: __________________________________________________________

E-mail: _____________________________________________________________

Category of membership required:   Single _____ Joint _____

Signature: ___________________________________________________________

Gift Aid Declaration (if applicable)
To enable the Society to claim back tax paid, in the event of this being agreed.

I am a UK tax payer
and I want the S.W. Herts Archaeological and Historical Society
to treat as Gift Aid donations all amounts paid by me until further notice.

Signed: _____________________________________________________________

Full name: ___________________________________________________________

Date: _______________________________________________________________

Please tick if you would like to set up a standing order for future years: _____

Please print and fill in the form, and send it with a cheque for the appropriate amount
and a stamped, addressed envelope to the Chairman:
SWHAHS, 83 Kingsfield Road, Watford WD19 4TP.