11 Application form

Press print screen and send with fee, £ 18 single, £25 family  to Mr J Jenkin 7 Trewirgie Hill Redruth TR15 2BT.
 
 
 
Carn Brea Mining Society Application for Membership

Please complete in BLOCK CAPITALS

Surname Mr/Mrs/Ms…………………………Initials or Christian names…………………………………..

Address……………………………………………………………….……………………………………………

Postcode……………………Telephone number including area code……………………………………….

Membership type (ring which is applicable) :- SINGLE     FAMILY     JUNIOR

Signatures for each member……………………………………………………………………………………….

Signature of parent/guardian for Juniors…………………………………………………………………………..

Date………………………………….Cheque enclosed for £…………………………………………………….