Application form


Title (Mr, Mrs etc.)  .............................................................
First name              ..............................................................
Surname                ..............................................................
Address                ..............................................................
                             ..............................................................
                             ..............................................................
E-mail address      .................................................................
Telephone:  day    .............................  evening ......................
Type of membership (please tick)
     Single ......  Single Concession  (Senior or retired) .............
     Joint  .......  Joint  Concession   (Senior or retired).........
     Junior (under 18. Please state age .............
     Full-time student ........................
Qualifications (not essential)  ...................................................

Other musical interests  ............................................................

Present appointment as organist if any ......................................

Would you like your name to be added to the locum list?
Sundays/ Weekdays/Area ...........................................
...................................................................................
...................................................................................

Your quarterly copy of our newsletter, Sequencer, will be delivered by e-mail if you have provided an address.
If you require a printed copy please tick ..............

Signature .................................................                   Date  ...........................

 

 

Subscriptions
Full time students - free
Ordinary  £13.50 
Joint         £15.00
Concessions £11.00
Joint concessions £12.00

 

Please print and send to 

Mr Alan Owen
11 Crossley Street
Sherwood
Nottingham NG5 2LF

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