Membership Application Form

 This form should be printed and sent by post with your remittance.
(click icon to print)

I would like to join the British Teilhard Association as a (please tick):

Full Member:	£20.00
Senior Citizen:	£15.00
Student:	£10.00
Life Member (Senior Citizens):	£400.00 (£250.00)

Your details (please print):

Title:	(Dr., Prof., Rev., Mr., Mrs., Ms. etc.)
First Name:
Middle Initials:
Surname:
Address:
Town:
County/State:
Postcode/Zip:
Telephone No:
Email Address:

Bank Standing Order: It would be very helpful administratively if you could pay this way.

A Bank Standing Order form is provided by clicking here for your convenience.

Gift-Aid Scheme: If you pay tax, you could help us further, at no extra cost to yourself, by contributing through the Gift Aid Scheme. Again, details of this are provided by clicking here.

Signature: _________________________ Date: _________________________

Please send the completed form to:

Canon Alan Nugent
The Subdeanery
18 Minster Yard
Lincoln
LN2 1PX

E-mail: subdean@lincolncathedral.com

Registered Charity No. 313682