South Hylton Local History Society (SHLHS)

Membership Application Form

(Please print out this form then complete it and forward it with your remittance.)

I/We wish to apply for membership to South Hylton Local History Society and enclose my/our cheque to the value of £……………   made payable to South Hylton Local History Society.

Title:               …………………………………………………………..

Name:             …………………………………………………………..

Postal Address: …………………………………………………………..

Town:              …………………………………………………………..

County:           …………………………………………………………..

Country:          …………………………………………………………..

Post Code:       …………………………

E-mail:            …………………………………………………………..

Tel. No:           …………………………………………………………..

Membership: £4.00 (renewable in May)

Please forward your completed Membership Application Form(s) to:

 Val Walker, The Membership Secretary, South Hylton Local History Society, 31 Rosemount, South Hylton, Sunderland, Tyne & Wear, SR4 0LD

Please Note:

The Society holds its membership details on computer.  We would appreciate your permission to store your membership details on our system.  The committee guarantees that the list will contain only those details entered on your completed application form.  Your membership details will not be passed on, in any shape or form, to any other organisation. As a formality, please complete

I/We hereby give permission to SHLHS to my/our membership details on an electronic mailing system.

Signature:             …………………………………………………………..

Block Capitals:       …………………………………………………………..

Date:                    …………………………

What I interest do you have in South Hylton?