Full-year membership application form (non-taxpayers only)

Name          ___________________________________

Address       ___________________________________________________________________

              ___________________________________________________________________

Tel           ___________________________________

E-mail        ___________________________________


No.   Category        Subscription     Name(s) (if different from above)    Cost

___   Full member(s)  £95 each         _____________________________        _______

                                       _____________________________

                                       _____________________________

___   Student(s)      £15 each         _____________________________        _______

                                       _____________________________

                                       _____________________________

      Donation                                                              _______


      Total                                                                 _______


I do not pay UK tax. I am therefore not eligible for the Gift Aid scheme.


Signed   ___________________________   Date  ______________


Applications to:

    Membership Secretary
    Worcester Concert Club
    56 Tunnel Hill
    Worcester
    WR4 9SD

enclosing:

 - this application form,
 - a cheque made payable to 'Worcester Concert Club' and
 - a stamped addressed envelope