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 £15 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. 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