Putney Music - Membership application form

Application form for membership

Why not join us and become part of one of London's most distinguished and exciting music societies? Meet new people with an interest in the appreciation of music.

Just fill in the details below, print off this page and send it to the Honorary Treasurer as indicated. We look forward to welcoming you.

To .....

Cynthia Butterworth
12 Grosvenor Avenue
London SW14 8BX

I wish to enrol/renew my subscription as a member of Putney Music
and wish to add a donation of £………..

I enclose my cheque for £………..
(Please make cheque payable to Putney Music)


Putney Music is a Registered Charity, Reg'n No. 1066524 and can
reclaim gift aid if members who are taxpayers sign this declaration.

Name: *Mr / Mrs / Miss / Ms

__________________________________

Address: __________________________________

__________________________________

Tel .No: __________________________________

email.: __________________________________

I am a UK taxpayer and want Putney Music to treat all subscriptions and donations I have made since 6 April 2000 and those I make from the date of this declaration until I notify you otherwise, as Gift Aid Declarations.

Signature ………………………………………… Date…………………..


I would like to receive/ I do not wish to receive Information about other societies or organisations
(please delete as appropriate)

Where did you hear about Putney Music? …………………………………………….

You may print this off or pick up a copy to be completed when you come to any meeting.

Return to Putney Music Membership Page