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print out the form, fill-out and then return to: The Membership Dept, The Vegetarian Society, Parkdale, Dunham Road, Altrincham, WA14 4QG or Fax: 0161 926 9182 (please do not fax Direct Debit forms) |
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Details
of the person/s for whom the gift membership is for:
Name (Ms/Mrs/Miss/Mr)
Address
Postcode Telephone No. e-mail Address: Date of Birth: I am a vegetarian Yes[ ] No[ ] Non-vegetarians will be enrolled as associate members THREE WAYS TO PAY -1. DIRECT DEBIT (see below - not by fax) 2. I enclose a Cheque/PO £_______________ 3. Please charge my
Mastercard/Visa/Amex/Switch Issue No. (Switch only)
Name on Card Signature Card holders contact number Please tick if you do not wish to receive information about: [ ] the Vegetarian Society's range of services [ ] information from other carefully selected charities [ ] special offers from vegetarian-friendly companies |
Adult Membership
Life Membership Overseas membership I would like to
make a donation to help the Society's valuable campaign work Gift Aid |
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Instruction to your
Bank/Building Society to pay by Direct Debit |
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Name
& full postal address of your Bank or Building Society
Name(s) of Account Holder(s):
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Originator's Id No:[7][2][4][3][6][6]Reference Number (for office use only)
Instructions to your Bank/Building Society Please pay The Vegetarian Society Direct Debits from the account detailed
in this instruction, subject to the safeguards assured by the Direct
Debit Guarantee. Signature(s): Date: Banks and Building Societies may not accept Direct Debit Instructions for some types of account |
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This guarantee should be detached and retained by the Payer
The Direct Debit Guarantee
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Many thanks for your support