This form is for you to print and complete - it is NOT for submission via the Internet.

LNHS: APPLICATION FOR STUDENT MEMBERSHIP

Student Membership subscription is £5 per calendar year and falls due for renewal on 1 January.
It applies to anyone aged under 18, and anyone over 18 receiving full-time education.
Please print this page, and fill it in using block capitals.
Post it to : Robin Blades, 32 Ashfield Road, London, N14 7JY
Enclose a cheque payable to : London Natural History Society.



Surname or family name:..................................................................


First Name: .....................................................................................


Address: ...............................................................................................................................


........................................................................................................... Postcode: ..................


Tel: .................................................. Email: ..........................................................................

Please also enrol the following as family member(s) at the above address:
(Additional subscription £4 per person. Family members enjoy all the benefits of the Society and may vote,
but receive no publications except an individual copy of the Programme of events).


Name(s) of family member(s): .........................................................................................


I enclose payment of: ...........................
To request a standing order form please write to the address above enclosing an SAE.

 

Year of birth ..................... ( optional). In which London Borough do you live?............................................
If you live outside the Greater London area please state your town or county.


Where did you hear about the Society? ....................................................................................................

What are your natural history interests? (e.g. plant, birds, insects, ecology, general interest, etc):


............................................................................................................................................................


Signed....................................................................................... Date.........................

Data Protection Act 1998: This information collected on this form is confidential and will not be released to any
third party. LNHS is a Registered Charity No. 206228.

GIFT AID DECLARATION

I would like any subscription payment or donation I make to the London Natural History Society from the date of
this declaration until further notice to be under the Gift Aid 2000 scheme. I know that I must pay an amount of income/capital gains tax at least equal to the tax the society reclaims in each tax year.

 

Signed...................................................................................... Date.........................