Printable Application for Membership

Information given below will be held on computer to ease our mailing list administration.
It will not be passed to third parties or be used for commercial purposes.

Title: Select Mr Mrs Ms Miss Dr Prof Rev Other	First name:	Last name:	Date of Birth:
Membership may be for two people at the same address. Please give details of second person below.
Title: Select Mr Mrs Ms Miss Dr Prof Rev Other	First name:	Last name:	Date of Birth:

Postal address (including postcode):


Telephone:


E-mail address:


How did you hear about the Malcolm Saville Society?:
Internet Recommendation Advert in book Bookshop Newspaper article Magazine article Radio programme Pamphlet Other

Membership is renewable each June 1st. Membership applied for now will last until 1st June 2009

UK membership: £10 per annum, European membership £12.50 per annum,
Rest of the world membership £16 per annum (Sterling only please).
Payments should be made payable to 'The Malcolm Saville Society'
After printing this form, please post it with your payment to
The Malcolm Saville Society, 35 Chapel Road, Penketh, Warrington, Cheshire WA5 2NG