Membership Application Form

Hemel Hempstead Photographic Society

Membership Application Form – Season 2019-20

Please complete this form using CAPITAL letters and ensure legibility

Surname ___________________ Forename ____________________

Address ________________________________

________________________________

________________________________

Postcode ___________________

Telephone Home: _______________________ Mobile: __________________________

Email: _____________________________

Date of Birth (U-18’s) Day______ Month______ Year_______

Data Protection:

We need your permission to contact you from time to time by Email and /or Telephone.

The Society will not pass on or distribute any information we hold on you without your express permission, unless required by relevant authorities. There will be limited circulation of your data within the Society, as necessary, for operational reasons.

The Society undertakes to safeguard all personal data held on members within reasonable practical limits.

Membership Fees:

Annual Membership Fee: £40.00 Circle payment & method below

Seniors (over 65 years) £37.00 Cash Cheque

Under 18 years Free Bank Standing Order

Weekly Attendance Levy £3.00 per session

Under 18 years £1.00 per session

Where did you hear about the Society …..Member,…Sainsburys,…Library,….Paper….

Other. (please state)

I wish to apply for membership of the Society and accept the data protection provisions.

Signed _________________________________

Date___________________________________

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