Membership Application Form

Hemel Hempstead Photographic Society

Membership Application Form – Season 2021-22

Please complete this form using CAPITAL letters and ensure legibility

Surname ……….……….………. Forename ……….……….……….

Address ……….……….……….……….……….

……….……….……….……….……….

……….……….……….……….……….

Postcode ……….……….

Telephone Home: ……….………. ………. Mobile: ……….……….……….

Email: ……….……….……….……….

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.

Annual Membership Fees (tick or put Y in one box): Payment method: Cash:

Age 18 to 64 £40.00 Cheque:

Age 65 & over £37.00 Bank Transfer:

Age under 18 Free Bank Standing Order:

If you wish to pay byBank Standing Order orBank Transfer the bank details are as follows.

Acc. No. 01469045 Sort Code – 40-24-07 Acc. Name Hemel Hempstead Photographic Society
Your Payment Reference: First name + Surname initial + subs e.g. “Jo B subs”

Weekly Attendance Levy is £3.00 per session (or £1.00 per session if you are under 18).

Where did you hear about the Society: ….Member, …Poster (where?), .…Library, ….Paper, ….Google, ….website, ….Facebook, ….other Social Media (which one?) ……………………….

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

Signed (or sent from personal email): ……….……….……….……….

Date: ……….……….……….……….

You may download the Membership form HERE