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St Ives Arts Club
Application for Membership
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Title
*
Mr
Mrs
Miss
Ms
Other
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First Name
*
Your answer
Last Name
*
Your answer
Address with Post Code
*
Your answer
Telephone Number - Mobile or Home
*
Your answer
Email Address
*
Your answer
Are you interested in being on the committee, or helping in other ways at the club? If so please expand below
Your answer
I wish to pay
*
Annual Subscription (1st October - 30th September) for Single Membership (£40)
Partial Subscription (1st April - 30th September) for Single Membership (£30)
Required
I will pay by the following payment method
*
Standing Order - Please set up through your own online Banking or Download a form
Bank Transfer: St Ives (Cornwall) Arts Club Society. A/C No. 65679062 - Sort Code 09 01 28
Cheque - please make payable to St Ives Arts Club
Cash - please enclose in a sealed envelope and deliver to the Arts Club
Required
Please tick the boxes below to confirm your consent to us using your contact details to keep you informed of club events and activities
*
Yes - I wish to be kept informed
No - please do not keep me informed
Required
Signed (please type your name below)
*
Your answer
Date
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