Please complete this form (giving your name and address in CAPITAL LETTERS), sign and date below, and then post with your payment to the membership secretary whose address is at foot of this form.

Title (Mr / Mrs / Ms / Miss / Dr etc.): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name(s): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Country & Postcode: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fax: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

E-mail Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Occupation (optional): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I/We wish to apply for Membership of the BerksFHS and enclose a cheque drawn on a London Clearing Bank made payable to BerksFHS for the sum of £ . . . . . . . . (as detailed below). See details for payments in non-UK currencies.

Signed: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date: . . . / . . . / . . . . . .  (For office use only: Membership No: . . . . . . . . . . . . . . . . )

Please help by telling us how you heard of the Berkshire Family History Society

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Data Protection Act 1998 - It is a condition of Membership that all member details may be held on computer. The details will be used for the distribution of information to members. They will not otherwise be disclosed to anyone who is not a member of the society."

Membership Secretary:

Bob Plumridge, Membership Secretary,
BerksFHS, Yeomanry House, 131 Castle Hill, READING. RG1 7TJ United Kingdom