Friends of Wilderness Wood

APPLICATION FORM                                       Please use BLOCK CAPITALS

I/We would like to join the Friends of Wilderness Wood

Names of adult(s)     (1) ......................................... (2) ......................................................

Address   .........................................................................................................................

 ...........................................     Postcode .........................   Tel. no...................................

E mail ...............................................................................................................................

Number of adults                   at £12.60                                          total           £...................

Number of children (3-15)       at £7.35                                            total           £...................

!/We enclose £...................  for membership for one year,

from (date) ......................................

(cheques payable to Wilderness Wood)

OR  Please debit my ................................card

No. _ _ _ _    _ _ _ _    _ _ _ _    _ _ _ _    start: _ _ / _ _   expiry: _ _ / _ _

issue no (if any)  _ _    security no:  _ _ _            Amount: ..........................

Please return this form to:

Wilderness Wood, Hadlow Down, East Sussex, TN22 4HJ

Telephone: +44 (0)1825 830509

Fax: +44 (0)1825 830977

email: enquiries@wildernesswood.co.uk

We reserve the right to refuse or terminate membership, subject to refunding unexpired membership subscriptions