To join Friends of Ferguson Heritage, please print out and complete this form, and send it to FoFH at the address below. Please use BLOCK CAPITALS...

Name:.............................................................................. Membership No. . . . . . . . . . . . . . . . .

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

.....................................................................................................Zip/Postcode..........................

Tel...................................Email.................................................................(omit if you prefer)

Please enrol me as a member in the following category (tick box). Prices are in UK pounds.
Membership runs from April to March
£18.00 Family (Husband & Wife, plus children) £17.00 Ordinary (one adult)
£14.00 Junior (Under 18 yrs) £14.00 Concessionary (Over 65 yrs)
£19.00 Overseas (EEC countries) payment by credit card or Sterling Bank Draft only  
£21.00 Overseas (non EEC) payment by credit card or Sterling Bank Draft only  
Friends of Ferguson Heritage Ltd, 32 Penland Road, Haywards Heath, W. Sussex RH16 1PW, UK

Instruction to your Bank or Building Society to Pay by Direct Debit
Name(s) of account holders
Originators i.d.No.
8 0 9 9 4 6
Ref. (Membership No.)
0 _ _ _ _ _
Bank/Building Society Account No.
_ _ _ _ _ _ _ _
Branch Sort Code
_ _ _ _ _ _
Instruction to your Bank or Building Society. Please pay Friends of Ferguson Heritage Ltd Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with Friends of Ferguson Heritage Ltd and if so, details will be passed electronically to my Bank/Building Society.
Name and full address of Bank/Building Soc.
.
.
.
. 		Signature(s) and Date

Banks and Building Societies may not accept Direct Debit instructions for some types of account