ASSOCIATION OF WOMEN CHARTERED SECRETARIES

Membership Application Form

NAME:Title: Ms/Mrs/Miss*

ADDRESS:

Post Code:

Membership Status: Student/Graduate/Associate/Fellow*

ICSA Membership No:

Telephone - Work:Home: Mobile:

E-Mail Address:

Job Status: Employed full time/employed part-time/self-employed/student/other*

Job Title (if employed):

Employer (Name & Address):

Name & type of business (if self-employed):

Membership of ICSA special interest groups:

Membership of other women’s organisations:

Membership of other professional bodies:

I apply for membership of the Association of Women Chartered Secretaries and enclose my subscription (£15.00 full, £7.50 if retired) for the year ending 31st December 2009. I also enclose a completed standing order form for subsequent years*. I do/do not* consent to the above information being reproduced in the Directory of Members. I do/do not* consent communication to be sent to me by e-mail.

Signed: ………………………………………… Dated:

* Please delete where appropriate

It would help if you could let us know the following:

How did you learn of the Association? ……………………………………………………………………

What attracted you to join? …………………………………………………………………………………

What events would you like to see in the programme? ………………………………………………….

Association of Women Chartered Secretaries

STANDING ORDER MANDATE

(Members)

Please complete this form in BLOCK CAPITALS

To: ………………………………………….. Bank/Building Society…………………………...Branch

Postal Address: ……………………………………………………………………………………………..

……………………………..………………………………………………………………………………

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Please payHSBC Bank Plc, Staines BranchSort Code:40-43-04

For the credit of:ASSOCIATION OF WOMEN CHARTERED SECRETARIES

Account Number:11421085

The sum of: £15.00/£7.50* NOW and on1st January annually, commencing on 1st January 20…….., until you receive further notice from me/us in writing.

Quote the reference……………………. and debit my/our account accordingly.

(To be completed by the Membership Secretary)

*Please delete which is not applicable [£15 annual membership/£7.50retired annual membership]

Please cancel all previous standing order/direct debit mandates in favour of: INSTITUTE OF CHARTERED SECRETARIES & ADMINISTRATORS –ASSOCIATION OF WOMEN CHARTERED SECRETARIES or WOMEN’S SOCIETY

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Member’s Details:

Account Name: ……………………………………………………………………………..…………….

Account Number:Sort Code:

Signature: ………………………………………………………..Date: ……………………………….

Banks may decline to accept instructions to charge Standing Orders to certain types of account other than Current Accounts

NOTE: the Bank will not undertake to:

a.make any reference to Value Added Tax or pay a stated sum plus V.A.T., or other indeterminate element

b.advise remitter’s address to beneficiary

c.advise beneficiary of inability to pay

  1. request beneficiary’s banker to advise beneficiary of receipt
  2. accept instructions to pay as soon after the specified date as there are funds to meet the payment if funds not available on the specified date

Payments may take 3 working days or more to reach the beneficiary’s account. Your branch can give further details.