RICHARD III SOCIETY – MEMBERSHIP APPLICATION FORM (continued)

To: Richard III Society Membership Department
E-Mediacy Limited
5 The Quadrangle Centre
The Drift
Nacton Road
Ipswich IP3 9QR
E-mail:

I wish to apply for membership of the Society and agree to abide by the Constitution (this is available on the Society’s Website).

Notes for Completion

  1. Tab through the form completing each section.
  2. Save a copy of the form to your hard drive on your PC.
  3. Attach your form to an e-mail and send to r download it and post to the above address.

Mr / Mrs / Miss / Other
Forename
Surname
Full Postal Address
Postcode
Telephone Number
E-mail Address
Date of Birth
Membership Category – please indicate which level of membership you require
£ / £ + 5% ‡
Full membership / 26.00 / 27.30
Family membership (all living at same address) / 32.00 / 33.60
Senior citizen membership (over the age of 60) / 20.00 / 21.00
Senior citizen family membership (all over age of 60) / 26.00 / 27.30
Junior membership (joining before 18th birthday) / 20.00 / 21.00
Student membership (+ 18 in full-time education) / 20.00 / 21.00
Overseas mailing charge (to non-UK address) / 9.00 / 9.45
Donation to Society (optional)

‡ there is a 5% surcharge payable on PayPal transactions. This should be added to your subscription rate as well as any overseas postal supplement.

NB: PLEASE ALLOW 21 DAYS FOR YOUR APPLICATION TO BE PROCESSED

Payment Method
Cheque payable to “Richard III Society”. Overseas members paying by non-sterling cheque or cheque not drawn on a UK bank should add the equivalent of £15 to cover exchange charges.
Paypal – Log on to your PayPal account and select the Send Money option. Then select 'Payment for Services' option and enter the Society's e-mail address which is . Enter the amount to be paid and specify GBP sterling. NB There is a 5% surcharge payable on PayPal transactions and this should be added to your subscription rate and any overseas postal supplement. Please complete the Message to Recipient box and enter 'New Membership' and your name. This is very important as it is the only way we can recognise the transaction and reference it with your application form.
Payment Method (continued)
ONLY COMPLETE YOUR CREDIT CARD DETAILS IF YOU ARE SENDING YOUR APPLICATION BY POST.
PLEASE DO NOT SEND CREDIT DETAILS BY EMAIL AS THIS COULD COMPROMISE THE SECURITY OF YOUR CARD
Credit/Debit Card: – MasterCard and Visa only. Please enter the following details:
Card number
Expiry Date
Security Number - last 3 digits of number by signature panel on reverse
Total sum to be charged - including 5% surcharge & any donation / £
Signature
Occupation/Profession of primary member
Please list all those included within your family membership. It would be helpful if you could also provide the ages of those under 18.