Membership Form

Shrewsbury Railway Heritage Trust

Membership Application/Renewal Form

Name: __________________________________________Title: ________

Address: _____________________________________________________

____________________________________________________________

_____________________________________________________________

Postcode: _______________

Telephone Day: _____________________Evening __________________

Mobile: _____________________

Email: ___________________________________________________

Special Interests: ____________________________________________

_________________________________________________________

_________________________________________________________

Subscription (tick) Individual £10        Family £15      Organisation £25

I also wish to make the following additional donation £ _____

Signature: _____________________________________________

Date: _______________

The information provided will be recorded under the principles of the data protection act 1998. Other than that required for the Companies Act, information will only be for the Trust’s use.

Please make cheques payable to Shrewsbury Railway Heritage Trust and return to: Mr P Hughes, 22 Highfields, Shrewsbury. SY2 5PQ (Tel. 01743 359853)

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