Durham Bird Club Membership Form

Name: ................................................................

Address:.............................................................

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

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

Post Code:  ............................... 

Tel. No. .......................................

Email address: ……………………………………………..

Subscription Rates
Ordinary/Family	£20
Concessions	£15
Junior	£5

Date of birth if Junior Member  ....../...../.........

I enclose Cheque/P.O./Cash for £ .........

or I wish to pay by Standing Order ..............

(a form will be sent to you, or you can download and print a form from the same web page where you found this one)

Signed: ....................................................

Date: ..........................

This form, together with the appropriate subscription, should be sent to:   

Derek Lawrence

Membership Secretary

46 Sackville Road

Sunderland

Tyne & Wear

SR3 4DH

Please make cheques payable to ‘Durham Bird Club’

How did you hear about the Durham Bird Club? .....................................................

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