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MIDLAND WIND & WATER MILLS GROUP

Please print off this form and send it to: MMG Membership Secretary, Mr. Tim Booth, 18 Hawne Close, Halesowen, West Midlands B63 3QQ.

I would like to become a member of the MIDLAND WIND & WATER MILLS GROUP and enclose my annual subscription of 10.00 plus ........ voluntary donation to the Restoration Fund. (Please complete the Standing Order Form below, or make your cheque payable to the Midland Mills Group).

NAME (Block letters) ........................................................................................

ADDRESS .........................................................................................................

.................................................................. POST CODE...................................

TELEPHONE.................................... EMAIL....................................................

OTHER FAMILY MEMBERS ..................................................................

SPECIAL MILL INTERESTS .....................................................................

STANDING ORDER MANDATE

NAME OF YOUR BANK ...............................................................

BRANCH ADDRESS .......................................................................................................

POST CODE...........................................

YOUR ACCOUNT NAME TO BE DEBITED: .........................................................................

SORT CODE: _ _ _ _ _ _ _ _ _ _ ACCOUNT NUMBER: _ _ _ _ _ _ _ _ _ _

Please pay NAT WEST BANK, BIRMINGHAM CITY CENTRE BRANCH, sort code 60-02-35 to the credit of MIDLAND MILLS GROUP

 

the SUM of ........ (SUM IN WORDS ............................................................)

IMMEDIATELY and thereafter ANNUALLY each 1st AUGUST until you receive further notice from me/us in writing. Please quote MEMBERSHIP number ......... and debit my/our account accordingly.

SIGNED .................................................................. DATE ................................

Please send this completed form, with cheque or Standing Order Mandate, to

MMG Membership Secretary, Mr. Tim Booth, 18 Hawne Close, HALESOWEN, West Midlands B63 3QQ

who will forward it to your bank.

 

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