Historical Diving Society - Membership Form PLEASE COMPLETE IN BLOCK CAPITALS
First name:
Last name:
Address:
Post code/Zipcode:
Country:
Telephone number:
Fax number:
Email address:
Website URL:
Type of Membership:
If applying for Corporate membership, state name of organisation and its main activity:
Please tell us a little about your interest in Historical Diving:
I wish to become a member of the Historical Diving Society. I enclose the appropriate fee and agree to abide by its Rules and Constitution.
Signed:
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Date:
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For Office Use
METHOD OF PAYMENT please tick
NAME OF CARD HOLDER:
PLEASE POST COMPLETED FORM TO: The Membership Secretary, 55 Carillon Court, Oxford Road, Ealing, London, W5 3SX, United Kingdom