SEG Membership Application Form

Membership Type: 1st November 2011 until further notice until 31st October 2011, each category £1.00 less than shown	Ordinary - £16.00 Family - £17.00 Student - £14.50 (under 19 fulltime)
Title:
Forename:
Surname:
Address Line 1:
Address Line 2:
Town/City:
County/State:
Postcode/ZIP Code:
Country:
*Telephone Number:
*Email Address:
*Occupation:
*Age (for student rate):*
*Where did you first hear about the Southern Electric Group?
Voluntary donation towards preservation activities:	£
Postage:

As a UK taxpaper, I would like any donation I have made on this form and all donations in the future to be through Gift Aid until I notify otherwise.

To qualify for Gift Aid, what you pay in income tax or capital gains tax must at least equal the amount we will claim in the tax year.

Before continuing, please read the Group’s constitution

**The application cannot be printed until you have pressed the button above**

*Please note that information under these headings is not stored on computer files. Information stored on computer files contains name, address and membership renewal details only.

Southern Electric Heritage Limited: A company registered in England (no. 3499370).
Registered office: 247 Davidson Road, Croydon CR0 6DQ.
Charity number: 1102973.

Forward the completed application, along with a cheque made payable to ‘Southern Electric Group’, through the postal service to:

Membership Secretary
Southern Electric Group
12 Heatherdale Close
Kingston upon Thames
Surrey
KT2 7SU
United Kingdom

MEMBERSHIP SUBSCRIPTION RATE (Effective in the UK from 1st November 2011 until further notice. Prior to that date, each category £1.00 less than shown below.)

ORDINARY £16.00 (Available to all)
STUDENT £14.50 (Available to full time students under the age of 19)
FAMILY £17.00 (Covers one member and immediate family)

OVERSEAS SUBSCRIPTIONS:
Please add to your subscription £0.50 for delivery to European Union countries, £1.50 to non EU European countries or £3.00 for other countries. This to cover the extra postage costs. All remittances to be in sterling.

SEG Membership Application Form

As a UK taxpaper, I would like any donation I have made on this form and all donations in the future to be through Gift Aid until I notify otherwise. To qualify for Gift Aid, what you pay in income tax or capital gains tax must at least equal the amount we will claim in the tax year.

Before continuing, please read the Group’s constitution

As a UK taxpaper, I would like any donation I have made on this form and all donations in the future to be through Gift Aid until I notify otherwise.

To qualify for Gift Aid, what you pay in income tax or capital gains tax must at least equal the amount we will claim in the tax year.