MEMBERSHIP AND SHARE APPLICATION FORM
Please complete Section A for membership and cash purchases of shares. If you wish to buy shares in 73082 Camelot and pay by monthly Bank Standing Order, instead of cash, please complete Sections A & B.
Section A
*I/We hereby apply for membership of the 73082 Camelot Locomotive Society and agree to be bound by the Rules and Constitution of the Society.
*I/We enclose a *cheque/Postal Order in respect of *my/our membership subscription for:-
......Full Annual Membership (£10.00) ......Junior & Senior Membership (£7.50)
......Joint Full Annual Membership (£15.00) ......Joint Senior Membership (£10.00)
......Life Membership (£200.00) ......Joint Life Membership (£300.00)
*I/We hereby apply to purchase ..................... £1 shares (minimum 250). *I/We understand that purchase of these part-ownership shares in 73082 Camelot entitle *me/us to free membership of the Society for FIVE YEARS.
*I/We enclose payment of £.......................... in respect of the above shares.
N.B. Please also complete Section B if you wish to buy shares by monthly Bank Standing Order.
NAME(S) (In block capitals please)...............................................................................................................................
ADDRESS (In block capitals please) ..............................................................................................................................
................................................................................................................................................................................... POSTCODE .................................
SIGNATURE(S).................................................................................................................................................... DATE ...........................................
*Delete as appropriate
Section B BANK STANDING ORDER
To (name of your bank) ....................................................................................................................................................Bank
Branch Address (address of your bank)............................................................................................................................
Code No. of Bank & Branch to be Credited Account to be Credited Amount to be credited
40-46-22 ; HSBC Bank PLC, 73082 Camelot Locomotive Society
Church Street, Weybridge, Surrey, KT13 8DF Current Account No. 91037293 £
Please credit the account of the 73082 Camelot Locomotive Society with £ .............................. payable monthly, the first payment commencing on
.................... 20 and thereafter monthly *until further notice/*a final payment on ..................................
*Delete as appropriate. My Account No ...................................................
NAME (In block capitals please)...................................................................................................................................
ADDRESS (In block capitals please)..............................................................................................................................
............................................................................................................................................................. POSTCODE ..........................
SIGNATURE...................................................................................................................................... DATE ....................................
Please return Section A, and Section B if you are buying shares by monthly Bank Standing Order, to:
Mr N. Devitt, Membership Secretary, 73082 Camelot Locomotive Society, 40 Lochaline St, London, W6 9SH
rev 05/2007