Membership Application

To become a member of Gillingham Local History Society and be a museum supporter please print out this form, fill it in and send it to the address below.

Category	Fee (£)
Individual Membership	12.50
Junior Membership (under 16 or still in full time education)	3.00
Life Membership	100.00
Overseas Membership	12.50
I would like to make a DONATION
TOTAL

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

Address ..........................................................

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Postcode....................................................

Tel No ...........................................................

Email ...............................................................

Signed ...........................................................

Please send to:

Gillingham Local History Society,
Gillingham Museum,
Chantry Fields,
Gillingham, Dorset
SP8 4UA
ENGLAND