London and North Western Railway Society
Membership Renewal

Membership Number

__________

Full Name

_______________________________________________
CAPITAL letters please

Address

_______________________________________________
_______________________________________________
_______________________________________________

Post Code

______________________

Country

______________________

Telephone

_______________________________________________

Email

_______________________________________________

I wish to renew my membership of the London & North Western Railway Society up to 31st December 2005. I agree to details of my membership being processed by computer for the purposes of membership administration as defined in the Data Protection Act 1998 - the data supplied on the membership form may be disclosed to other members of the Society, but will not be disclosed outside of the Society.

Signed

_______________________________________________

Date

______________________

Age
(if under 18)

______________________

I enclose a Cheque/Postal Order for £20 subscription (Overseas members outside Europe please add £5 for surface mail or £10 for airmail, all in sterling if possible). Remittances should be made payable to the “L & N W R Society”.

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