Please complete the form.  Print it out and send it with your subscription to the Treasurer.

Items marked * are required.

Note: This is for committee use only.

Continue on a separate sheet if necessary

 

I enclose a cheque for £ payable to:

Northamptonshire Association for Local History (NALH)

 

I have read the information about the Data Protection Act and have no objection to the details above being circulated to other members of the Association

 

Send the completed form together with your remittance to:

The Treasurer,
Northamptonshire Association for Local History, 6 Bakers Lane, Norton, Daventry, NN11 2EL.