Name of Society (please PRINT)

………………………………………………………………………………………………………………...

Please tick the Annual Membership rate you require –

O £15 Society affiliation

O £20 Society affiliation with Medal and Certificate

Position of Contact (e.g. Hon Secretary)

……………………………………………………………………….

Please complete your name and address in capital letters –

Title ( e.g. Mr, Mrs, Miss, Ms) ………………………… Initials ………………………………

Surname ……………………………………………………………………………………….

Address ……………………………………………………………………………………….

………………………………………………………………………………………………..

………………………………………………………………………………………………..

Postcode ……………………………………………

Telephone ………………………………………….

E-mail …………………………………………………

Please send this form with your remittance (cheque or postal order payable to National Sweet Pea Society) to the Membership Secretary –

Mr R Parsons, Primrose Cottage, Clayton Lane, Bracklesham Bay, Chichester, West Sussex, PO20 8JQ

Due to the expense, the Society does not maintain facilities for payment by credit or debit card.

(Overseas Societies – please ensure that cheques or bankers drafts are drawn in UK pounds sterling)