Membership Entry Form

STRANRAER AND RHINS OF GALLOWAY AGRICULTURAL SOCIETY LTD

Application Form for Membership
Primary Member*

First NameLast Name
Other members (separate lines if multiples)
Address Line 1*
Address Line 2
Address Line 3
Postcode*
Telephone*
Email*

Confirmation Emailexample@example.com
Number of memberships at £16 per person*
Donation
Total Payment
Payment method (Please add Surname & number of memberships as the reference)*

Bank TransferCheque
Please submit this form as soon as possible.

Entries will not be accepted until full payment has been received. Payment can be made by cheque (made payable to “Stranraer & Rhins of Galloway Agricultural Society") or by bank transfer:
Account Name: Stranraer & Rhins of Galloway Agricultural Society
Sort Code: 83-27-14
Account Number: 00257407 (If paying by bank transfer please make it clear who you are)

Thank you.
Should be Empty:

STRANRAER AND RHINS OF GALLOWAY AGRICULTURAL SOCIETY LTD