Waxbill Finch Society
Membership Application (2010/11)

NAME ..................................................................................................................................................

ADDRESS ............................................................................................................................................

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

POST CODE .........................................................................................................................................

TEL. CODE and NO. ..............................................................................................................................

EMAIL ..................................................................................................................................................

Subscription paid: £12.50 / £20 / Junior (Free)

New member / Renewal

Only your name and telephone number will be published on the membership list

Do you have any objection to Branch Officers having a record of your address?
YES / NO

---

The membership form can be printed from .pdf format here, or print out this screen if you prefer. Please send your completed form with your payment to the Membership Secretary at the address below:

John Dodwell
28 Westway
Nailsea
Bristol
BS48 2NB

Cheques and Postal Orders should be payable to The Waxbill Finch Society

---