home	Staffordshire Parish Registers Society – Please print off, complete and post these Forms if you wish to become a Member and/or make a donation to the work of the Society – OR you can do it ONLINE and subscribe or renew by PayPal

Part A

Application for Membership

I wish to become a member of the Staffordshire Parish Registers Society.
I enclose a remittance for the year 2011

[ ] 2011 Individuals - UK and Europe - £5.00 (extremely good value)
[ ] Individuals -  Rest of world      - £7.50 (inclusive of surface mail). 
[ ]            Organisations (invoiced subscriptions) - £10.00
[ ] Donation of £……………

Total £

If airmail is required, please write for a quotation, enclosing an IRC.

I understand that payment is due on January 1st each year (Payment in £ Sterling only please).

Name..............................................................................................
Address..........................................................................................
........................................................................................................
.......................................................................................................

Post code .................................... Country ............................

Email address.................................................... Date…………………………

Please send to: Dr. Peter Bloore, 35 Middlefield Lane, Hagley, Stourbridge, DY9 OPY, UK
(Cheques should be made payable to Staffordshire Parish Registers Society)
Please enclose a stamped, addressed envelope (UK) or International Reply Coupon if
an acknowledgement is required.

Please note that members' name and address information is held on computer for Society
mailing purposes only. If you object to this please inform the Honorary Secretary
__________________________________________________________________________________________

Part B

GIFT AID DECLARATION FORM

I would like the Staffordshire Parish Registers Society to treat as Gift Aid all subscriptions I make,
or have made, to the Staffordshire Parish Registers Society.

I will notify the SPRS when I wish to cancel this arrangement or when I cease to pay Income Tax.

Signature………………………………………………..

Date…………………………………………………..

Completed forms should be sent to:
Dr. P D Bloore, 35 Middlefield Lane, Hagley, Stourbridge, West Midlands, DY9 OPY

Copyright SPRS 2011

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Page last updated:  11 January 2011