Basic Information (Please Print)

      Date: …... /........ /........

      Name:     :...........................................................................

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

      Town:   .................................................

      County:  ............................................. Postcode:........................Email: ........................................................


     Membership Information

           Name you prefer on your group name badge: ….............................................................................

           Phone number(s): …............................................. Mobile number: …...........................................


     Membership Levels Please circle one:                                                     You can also pay by bank transfer to:

           INDIVIDUAL.... 15.00 Cheque or Cash                                                   Preseli Astronomy Group

           FAMILY............ 20.00 Cheque or Cash                                                    Sort Code: 53-50-30

           OTHER.............. 10.00 Cheque or Cash                                                   Account Number: 52150968

      Names of additional family members (Family Membership Only)                ...............................................................................................

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

     

If you are unable to attend a regular society meeting, you may join by posting this completed form together with a cheque payable to "Preseli Astronomy Group" to: Mr.Phil Kingdom (Membership Secretary), Kimberley, Pentlepoir, Saundersfoot. SA69 9BN