Are you an Old Aytonian?
Would you like to join the Old Scholars' Association?
PLEASE PRINT THIS PAGE
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YOUR NAME AND ADDRESS |
|
| First name(s) | |
| Family Name | |
| Maiden Name | |
| Address - line 1 | |
| Address - line 2 | |
| Town / City |
|
| County / State | |
| Post / Zip Code | |
| Country | |
| Telephone Number | |
| E-mail address | |
| At Ayton - from/to | 19...... to 19....... |
| I
/ We (please delete as applicable) wish to become
an annual Member(s) of Ayton Old Scholars' Association (The annual subscription is £5 per annum - £2.00 extra per annum for partners) |
UK£ |
| I / We wish to pay our annual subscription by cheque - or - I / We wish to pay our annual subscription by Bankers Order (please delete as applicable) | UK£ |
| Bankers Order: To the Manager Bank Ltd | |
| Bank Address: | |
| Please
pay to HSBC Bank, Middlesbrough (40-33-01) for the credit
of Ayton Old Scholars Association, Account No. 50116351 the
sum of £................................... (words.............................................................) on 1st April 20..... and annually on the same day until this order is revoked by me, debiting my / our Account No....................................... |
|
| Signed: |
|
| I
/ We (delete as applicable) wish to become Life Member(s)
of Ayton Old Scholars' Association (Life membership is £100.00
and £80.00 for partners) I / We are over 50 years. (£50.00 for those joining at age 50 or over and £40.00 for partners, also aged over 50) |
UK£ |
Please post this form with your cheque
- if applicable - to: AOSA Hon. Treasurer,
William Pine, 20 Meadowfield, Stokesley,
North Yorkshire TS9 5EY
Tel: 01642 711 505
e-mail: william_pine@lineone.net
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