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Tipton & Wednesbury Family History Society

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APPLICATION FOR MEMBERSHIP

Print out, fill in & return to the Temporary Membership Secretary:
Mr. D. Ogden,
18 Hobs Road,
Wood Green,
Wednesbury,
West Midlands,
WS10 9BD,
England

BLOCK LETTERS PLEASE


Mr / Mrs / Miss / Ms / Dr_____________________________
Address : _________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Postcode / Zip _________________________
Telephone No. _________________________
Email Address: _____________________________________

I wish to become a UK / an outside UK member of the Society commencing 1st April 200....

SUBSCRIPTION RATES [Renewable on the 1st of April each year]
Membership is free until at least April 2002 when the position will be reviewed.