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APPLICATION FOR MEMBERSHIP

Please print and complete this form and return with payment to the address below

(Overseas members may pay by cheque in local currency to the equivalent sterling amount)

Title:- Mr Mrs Miss Ms Dr etc...................( Indicate as appropriate)

First Name:-.................................................................................................................................................................

Surname:-.....................................................................................................................................................................

Address:-.....................................................................................................................................................................

....................................................................................................................................................................................

City/Town:-.................................................................................................................................................................

County:-.....................................................................................................................................................................

Country:-........................................................................................... Postcode:-...........................................................

Telephone No.:- .............................................................................

e-mail address:- ........................................................................................

I Enclose:- £................ for one/three years membership (delete as appropriate)

Please make cheques payable to TYRRELL FAMILY HISTORY SOCIETY and return form to:-

Mrs Patricia Knights

Corner Croft

Hollingdon Road

Hollingdon

Buckinghamshire LU7 0DN