Membership Form
Forename
Surname
Email
Address 1
Address 2
City
County
SINGLE MEMBER £6.00
JOINT MEMBER £9.00
NOTE: Joint Membership is open to a Single Member PLUS one named member. Select Relationship option.
Type of MembershipPlease select the type of membership
FOR OFFICIAL USE ONLY
Received:
Signed:
Treasurer
Please complete, print (use the button below) & return with your cheque to:
Bob Newton, 14 Launceston Close, Park Hall, Walsall WS5 3EG
Cheques payable to “The Friends of Highgate Brewery”
Membership Secretary
Postal Code
*Country
If renewing, place an X in the box
Phone No.
* Relationship
* Membership type
Friends of Highgate Brewery
You can complete this form before OR after printing. * make selections before printing
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