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Full |
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Full |
| Surname | First Name(s) | |
| Address . . Postcode |
Telephone Fax: |
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| Occupation(s) | ||
Children's Names |
Country of Origin |
Birth Date |
Date of
Adoption |
Date of
Adoption |
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| WOULD YOU BE WILLING TO
HAVE YOUR ADDRESS AND TELEPHONE NUMBER CIRCULATED TO
OTHER MEMBERS OF THE ASSOCIATION? Note: If you do not agree to this, your address details will not be included in the annual membership list and you will not receive a copy of it. |
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| WHERE DID YOU HEAR ABOUT AFAA? | |
| THIS INFORMATION WILL BE STORED ON A COMPUTER. TO SATISFY THE REQUIREMENTS OF THE DATA PROTECTION ACT, WE NEED YOUR PERMISSION. PLEASE TICK TO INDICATE YOUR AGREEMENT. |
I/WE ENCLOSE £12 FOR MEMBERSHIP (please make cheque payable to AFAA)
| If you would prefer to pay by standing
order (we certainly prefer this as it saves on
administration costs), please complete the bankers order
form below and, after recording its details, it will be
forwarded to your bank. |
| SIGNATURE: | DATE: |
PLEASE RETURN THE FORM TO: MR. M. THOMAS,TREASURER
AFAA, Registered Charity No. 1003274 |
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BANKERS ORDER FORM I, _____________________________(Full name in BLOCK CAPITALS) of (Address)_______________ ___________________________________________________________ Post Code ______________ request you to pay to National Westminster Bank , Sevenoaks Branch (60 19 02) for the credit of AFAA (Account No. 31058434) the sum of Twelve Pounds (£12) immediately and thereafter every 2nd January until you receive further notice from me in writing. TO ISSUING BANK Please quote reference number _____________________(This will be completed by AFAA) DATED __________________________SIGNATURE_______________________________________ To: (Name of Bank and full address of branch - BLOCK CAPITALS) ______________________________ __________________________________________________________________________________ Account Number _____________________Bank Sort Code______________________ |
PLEASE RETURN THE
FORM TO: MR. M. THOMAS,TREASURER AFAA, |
