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Regency Square Area Society: Membership

To: Sue Paskins c/o 39 Regency Square, Brighton, BN1 2FJ

Please enrol me as a member of the Regency Square Area Society for the year 2010/2011 in the category of membership shown below (please circle your choice):

Note: Ordinary, family and senior citizen members must live in the Society's area

Ordinary Member

£4.00

Family (2 adults plus any children) £4.50
Senior Citizen £3.50
Associate (non-resident) £3.50
Business (non-resident) £6.50

Please add a donation to your subscription if you can. Associate members who live more than 15 minutes walk from Regency Square are asked to include a donation to cover the cost of mailing ten one page newsletters per year.

Basic subscription

£________

Optional donation £________
Total enclosed £________

Name(s)
_____________________________________________________________

Street address
_____________________________________________________________

_____________________________________________________________

To receive newsletters by email rather than on paper, please put your email address below. (Please include your street address above to confirm your membership category.)

_____________________________________________________________

Please make cheques payable to Regency Square Area Society.

Members' details are stored on computer for administrative purposes only