PLEASE PRINT THIS PAGE AND RETURN TO DORSET EXPEDITIONARY SOCIETY LTD.

DES Membership Application Form.

I wish to apply for Individual/Family/Corporate* membership of the Dorset Expeditionary Society.

Name:................................................................................................................................
(PLEASE PRINT CLEARLY)

Address:...........................................................................................................................
...........................................................................................................................................
.............................................................................................Postcode:............................
Phone:...............................................................................................................................
Organisation*:.................................................................................................................
(if applicable)
Expeditions:......................................................................................................................
(if applicable)

Individual membership is £15 per annum.
Family membership is £25 per annum.
*Corporate membership for schools, clubs and business is £25 per annum.
Friends wishing to donate £100 per annum become a Vice Patron of the society.

I wish to pay my subscription annually by Direct Debit/Cheque/Gift Aid**.(delete as applicable)

**If you are a taxpayer, please do consider 'Gift Aiding' your subscription. This costs you nothing extra, but is of great benefit to the Society.

'Gift Aid' and 'Direct Debit' forms can be obtained directly from the Secretary. Please complete this form, and request the additional paperwork.

I am/am not willing (delete as applicable) to Gift Aid this sum.

Completed forms should be returned to the Secretary:

The Secretary,
The Dorset Expeditionary Society,
Lupins Business Centre,
1-3 Greenhill,
Weymouth, Dorset
DT4 7SP

Dorset Expeditionary Society Limited. Company no. 3598471, Registered Charity no. 1071217.

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