Friends of the Newport Ship

Friends of the Newport Ship
Membership Application Form

Please print and complete this form then send with your subscription/donation to:
The Membership Secretary, Friends of the Newport Ship,
c/o FWD Law, Clifton Chambers, 12 Clifton Road, Newport, NP20 4EW

Name:

Title:

First name:

Last name:

Renewal? Please insert membership number:

Address:

Postcode:

Telephone number:

Email address (please print):

I wish to become a Friend of the Newport Ship and enclose my subscription of (please tick one box):

Individual membership (£5)		Family membership (£8)
Corporate membership (£10)		Overseas membership ($20US)

I wish to make a further donation of

I enclose payment by cash / cheque (please circle as appropriate).
(Please make cheques payable to Friends of the Newport Ship.)

Total £

Would you like to help in other ways? Please indicate what you can offer (e.g. secretarial, design, professional services, catering, anything at all?)

Please tick this box if you wish to be sent Members News updates via Email

Signature:

Date:

Office use only:

Fee:

Date:

Mbship:

Comment:

Don: