You can also download a .pdf version of this form.
All completed forms must be sent with a cheque to the Membership Secretary at:
M.R. Society Membership Secretary, Alan Cox, 35 Royston Drive, Belper, Derbyshire. DE56 0EL
The membership rates (starting from Jan 1st 2017) cover the period January to December and are:
If paying by post please make your cheque payable to “The Midland Railway Society”.
Or you can use this form to pay by PayPal:
When paying by PayPal you will be directed to a secure online application form where your personal details may be submitted. Please note that by using the above PayPal subscription button, your membership will automatically be renewed on the same date every year unless we are advised in advance of that date that you do not wish to renew in which case it will be cancelled. We hope of course that this will not be necessary and that you will continue to enjoy membership of the Society for many years to come.
If you have any membership queries then the Membership Secretary, Alan Cox, can be contacted through email to firstname.lastname@example.org.
The Chairman of the Society, David Hunt, is also available to discuss the Society generally via email to email@example.com.
|Date of birth:||________________________________________|
If a modeller please specify scale:
My interests in the Midland are (please tick):
Geographical Areas (specify):
I agree to my name, address and interests etc. being included on the Membership List which is issued to those members requiring a copy. YES / NO
I would like the Midland Railway Society to treat my subscription as a Gift Aid donation. YES / NO
Please find enclosed a cheque to the value of £_____ payable to “The Midland Railway Society”.
Under the terms of the data protection act 1984, I agree that my personal details may be recorded on a database for the sole use of the Midland Railway Society.