Registration Form

Personal Details = required

Full Name

Home Address

Home Phone

Mobile Phone

Email Address

Alternate Email

Date of Birth

Gender

Male Female

Occupation

(Please indicate if you would be willing to help the club should it need your expertise.)

Membership Start

When would you like your membership to start?

As Soon As Possible Specific Date

Preferred Start Date
(if applicable)

Membership Category

Please select your preferred membership category

Category	Joining Fee	Cost
Standard Membership A person aged 18 and above. The joining fee is to cover the one-off cost of a share (price £15.00) that has to be purchased with this type of membership. The share cost does not occur on subsequent renewals. Only available to people aged 18 or over.	£15.00	£50.00
Discounted Membership A person who does not have any Associate Members connected with their Membership and meets any one of the following criteria:- is a full time student not in full time employment is 65 or over at the age of next renewal lives outside a 20 mile radius of the Society's Site Only available to people aged 18 or over.	£15.00	£25.00
Junior Membership for 14-17 year only Only available to people between the ages of 14 and 17 inclusive.		£25.00
Family Membership A person aged 18 and above, plus Partner over 18, if there is one, and any children under 18 † (Associates)	£15.00	£50.00

Data Protection

I understand that any personal data I provide on this site will be processed in accordance with the Terms & Conditions and Privacy Policy. I have read and agree to the Terms & Conditions (https://www.malden-dsme.org/Home/TermsAndConditions) and the Privacy Policy (https://www.malden-dsme.org/PrivacyPolicy;).

Signature

Date

Please return completed forms to: Mr. Derek C. Smith, Cherry Trees 4 St Catherines Drive, Guildford, Surrey, GU2 4HE, England

Use this form to send an email to another member. You may only send to one member at a time. Your registered email address will be passed on to this member but you may also include alternative contact details.

Note: Emails sent via the website are not entirely private. A copy of every email is held on the database and this can be accessed by the club officers using the Sent Emails page.

From

Alternative contact email

Another email address which the recipient can use to contact you.

Alternative contact details

Other contact details which the recipient can use to contact you e.g. phone number.

Subject

Message

Copy this message to my email address

Outdated Browser

Sandbox Mode