APPLICATION
FOR MEMBERSHIP OF THE JSPCA
I/We
would like to become a member(s) of The Jersey Society for the Prevention of
Cruelty to Animals Inc. (Please complete form in block letters please)
Subscription
(please
select):
Adult
£10.00
OAP £5.00 Junior under 16 £3.00
per
annum per person
Names:
(Mr/Mrs/Miss/Ms)
Address:
..
Post Code:
.
E-mail address: .......................................................................................................
Telephone .(home) .(work)
If you would like to pay your annual subscription by Bankers Order, please complete the following details and return to the Animals' Shelter:
To
the Manager:
Branch
address:
Account
in the name
of:
Account
number:
.....
Please
pay, upon receipt, £
.. and annually thereafter on 1st
January, £
to the JSPCA account (number 20491790, sort code
16-10-28), Royal Bank of Scotland International, Bath Street, St Helier.
Signature:
.
Date:
Alternatively you can pay by cheque. I enclose a cheque for £ .. Please return payment along with this completed form to the Animals' Shelter.
I
hereby agree to be bound by the rules of the Society. (Copy can be obtained
directly from the Animals Shelter.) I
hereby agree to inform the Honorary Secretary of any changes of address. I
understand that all information will be sent to the last address supplied
to the Honorary Secretary by the member.
Signed
(by all parties)
..
.
Date