To Pay by Credit Card, Print this Form

Gloucestershire Family History Society

What do you require? Please check the appropriate box.

Membership (Application form must be enclosed)

Goods   Services

Details of goods, vouchers or services_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I wish to pay by Master Card / Maestro / Visa / Electron / Solo / JCB (delete as applicable)

I authorise you to debit my account with the amount of £ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
We will charge in sterling. Foreign card-holders are billed in their local currency at a variable rate based on a spot commercial rate.

Card Number   - - -
Security Code (last 3 or 4 digit number on card signature strip):
Issue No. (Maestro (Domestic) and Solo cards):
Valid from:   Expiry date:

For Goods and Services send to:
GFHS, Spread Eagle Court, Northgate Street, Gloucester GL1 1SL
OR Telephone your order to +44 (0)1452 524344 - (UK - 01452 524344) - Telephone orders available only on Tuesdays, Wednesdays and Thursdays from 10am till 4pm.

For New or Renewed Membership send to the appropriate Membership Secretary:

Membership Secretary for Surnames A-M

Sheila Coatsworth, ‘Ballaghy’, Pittville Circus Road, Cheltenham, Gloucestershire GL52 2QE

Membership Secretary for Surnames N-Z

Noel Stevens, 3 Severn Close, Maisemore, Gloucestershire GL2 8ET

NB For administration purposes we must keep your personal details on a computer.

Data Protection Act 1998. Registered Number: Z503130X