APPLICATION  FOR personal MEMBERSHIP

YEAR 200  

Name                     .................................................................................................... 

Address                 .................................................................................................... 

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

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

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Post Code              .................................

Telephone               .................................

Email address        ....................................................................................................

Do you object to the Association holding your membership record on computer?           Yes or  No

Signed                .................................................................................................... 

Date                    .................................................................................................... 

 

Please print and complete the above form, enclose a cheque for  £10 payable to Cheshire Local History Association and send to: -

Cheshire Local History Association

Cheshire Record Office

Duke Street

Chester CH1 1RL

Please enclose SAE if receipt required)


Copyright © 2000. Cheshire Local History Association. All rights reserved.
Revised: June 28, 2008