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Application to join the Friends of the BBC World Service
Title:
Name:
Address
Phone: Home
Phone: Work
Fax:
Occupation:
Email:
I / We wish to join the Friends as (tick where appropriate)
Life Membership
Corporate Membership
$500.00
Double
$300.00
Single
$250.00
Annual Membership
Corporate Membership
$ 75.00
Double
$ 50.00
Single
$ 30.00
Donation
$
Enclosed is a cheque for
$
To comply with the Privacy Act 1993 the information on this form is collected for use in trust related matters, only. I / We consent to my / our details being used in this manner.
Signature:
Date:
Please post with cheque to:
The Honorary Secretary The Friends of The BBC World Service. PO Box 28 - 662, Remuera, Auckland.
