Bourne Civic Society
Heritage Centre/Baldocks Mill
21 South Street, Bourne, Lincolnshire PE10 9LY. Telephone: 01778 422775

Registered with the Civic Trust
Registered Charity 512420

President Baroness Willoughby de'Eresby

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Application for Membership of the Society

I/We wish to join the Bourne Civic Society

Membership Category :  (Family = 2 adults and their children under 16)

Please find enclosed the sum of

For the first annual subscription
Title : 
Last Name : 
First Names : 
Address : 
Town/ City : 
County : 
Post Code :  
Telephone : 
Email : 
Date:
 
Signature : 

The Society's year runs from 1st January to 31st December.

 

Please complete this form, Submit or print out (Adobe Reader required) and send it with the appropriate subscription fee to:
The Membership Secretary, Bourne Civic Society,
Baldocks Mill, 21 South Street, Bourne Lincolnshire PE10 9LY United Kingdom

Page last updated  23/01/2008

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