SAM 35

MEMBERSHIP APPLICATION FORM

Please complete the details listed below in block capitals and then send this form to:

Alan Chatfield, 27 Causway Terrace, Watchet, Somerset, TA23 OHP

e-mail and for Paypal payment: - secretary-sam35@tiscali.co.uk

Please enclose: -
1) Cheque or postal order payable to SAM 35, £21 FOR UK* or £30 FOR OVERSEAS
MEMBERS. Overseas members who wish for ‘Speaks’ by airmail please add: For EU
countries £4 and for USA and other countries £9. Payment may be made by credit card
using Paypal.com. For details of this arrangement please e-mail the membership
secretary. There will be a small extra charge to cover Paypal commission charges. Please
note that new UK members need only pay £12 after 1st June.

2) A stamped self-addressed envelope.

3) If renewing your Sam membership card

Name______________________________________________________________________
_

Address_____________________________________________________________________

___________________________________________________________________________
_

Post Code __________________________Telephone Number _____________________

E-mail address ____________________________________________________________

Please tick if this application is a renewal ¨ A new membership ¨

Sam 35 Membership number (new members leave blank)_______________________

*a) BMFA number and I undertake to keep my subscription current

*b) I do not fly models at any time (magazine subscription only)

*You must fill in or delete either a) or b) above.

Data Protection Act. The information you provide on this form will not be disclosed to
persons outside of the Society. Contact details may be passed to bona fide members should
they wish to contact you about Society business. If you do not wish for your details to be
disclosed to other members please tick this box. o
Note: Please do not use staples