Loughton & District Historical Society
Membership Application: 2020 - 2021 Season

To join the Society for the current season (October to May) print this page, [Ctrl P] or better still use either the more printer friendly PDF version or Word version.
Complete it and send it with the appropriate subscription to:

Dr Chris Pond
Forest Villa
Staples Road
Loughton
1G10 1HP

If you join the Society, please note:- Information you supply on the application form will not be disclosed to any other member without your consent, and never to any outside party or organisation. A postal address is needed so that you may receive Newsletters if unable to collect them at a meeting. If you give an e-mail address, please sign the form to indicate that the Society may use it to:- Acknowledge your subscription if sent by post; advise you of any changes or additional information regarding meetings or other events. If you are unable to print the form, please write the information clearly on a piece of paper and sign it as appropriate. You may withdraw your consent as above at any time.

Your membership card will be sent with the next Newsletter, but if required earlier please enclose a stamped addressed envelope.

Name(s) ............................................................

Address ............................................................

............................................................................

............................................................................

Post Code ........................................................

Telephone ........................................................

Email ................................................................

(Please Write Clearly)

I / We consent to the Society contacting me / us by e-mail as described on the website application form page     Signature(s)                   Date

....................................................................................................................................................................

I / We enclose a cheque payable to Loughton & District Historical Society

for  £ ............

Subscriptions : Individual £10; Family £15 (covers two or more people at one address and is primarily intended for those who attend meetings)

Registered Charity 287274
© 2020 LDHS