AIRSHIP HERITAGE TRUST - MEMBERSHIP FORM (WEB APPLICATION)

Application for of the Airship Heritage Trust.
Year to the 31st December
Title: First Name: Surname:
Address:
Post Code:
Date of Birth:
Email Address:
Occupation:
I enclose a remittance of PAYABLE TO THE AIRSHIP HERITAGE TRUST.
or (if a UK resident)

have completed the Standing Order Form below. Please return the WHOLE form to:
Mr Brian Harrison,
Membership Secretary
Airship Heritage Trust
9, Quaggy Walk,
Blackheath,
London
SE3 9EL
STANDING ORDER FORM

To: The Manager of Bank plc.

Address:
Post Code:
My A/c #:

Please pay to:

The Airship Heritage Trust
Account Number : 31563866

HSBC
Unit 2 Marlowes
Hemel Hempstead
Hertfordshire

Sort Code : 40-24-07

The Sum of £25 on receipt of this instruction and then £25 (on the 1st January 2011 and on the 1st January annually until further notice).
Signed:

___________________________________________________________
Date:
 _____________________