Cleveland & Teesside Local History Society

(You can print out this form and then complete it or complete it on screen and then print it off to send to us.)
 
I/we wish to apply for membership of the Cleveland & Teesside Local History Society 
and enclose a cheque/PO to the value of 

Cheques should be made payable to the 'Cleveland & Teesside Local History Society'
 
I/we do not object to the Society holding my name on computer file.
 
 
 
Dr/Mr/Mrs/Miss/Ms/Mr & Mrs 

Surname & initials 

Postal Address 

Postcode           Country 

E-mail             

Tel no.         

Subscription Rates for 2007
(in pounds sterling)

 
Individual Membership							£12.00
Household Membership						£13.00
Pensioners							£  9.00
Pensioner Couples							£10.00
Schools/Colleges/Libraries etc.						£15.00
Fulltime students/under 18's & unemployed people				£  6.00

Overseas surcharge							£  5.00

Please send completed forms and cheques to:
C&TLHS, 43 Petrel Crescent, Norton, Stockton-on-Tees.TS20 1SN.