Worcestershire Industrial Archaeology &
Local History Society
(WIALHS)

Membership Application Form

Title_________  Surname___________________  Forename__________________________

Title_________  Surname___________________  Forename__________________________

Address_____________________________________________________________________

___________________________________________________________________________

Town/City____________________________        Postcode__________________________

Post Code______________________              Telephone No_________________________

Your email address_______________________________________

Your particular interest:________________________________________________________

___________________________________________________________________________

 

Membership cost £10 per person or £18 for a couple living at the same address.
Cheques payable to WIA&LHS.

Please print this out and send the completed form and your subscription to:-
Mrs S. McCurdy

56 Camp Hill, Worcester. WR5 2HG
mailto:suemccurdy@yahoo.com