To join the City of Rochester Society, print the form below, complete with the relevant details and send it the the address on the form.
MEMBERSHIP APPLICATION FOR THE
CITY OF ROCHESTER SOCIETY
Registered Charity No. 252603
To the Membership Secretary, 32 Powlett Road, Frindsbury, Rochester, Kent ME2 4RD
*I/We hereby apply for

Adult Membership

 £7 per person p.a.

Junior Membership
(under 16 years of age)

 £5 per person p.a.

Corporate Membership

 £21 per annum

Life Membership

 £70
*I/We enclose a cheque / postal order for £
*I/We submit a completed Bankers Order Form
(*Delete where appropriate)

NAME AND ADDRESS
(BLOCK CAPITALS PLEASE)
Name (Mr/Mrs/Miss/Miss.......................................................................
Address .................................................................................................
...............................................................................................................
Post Code....................................Country..............................................
Telephone Number ................................................................................
I have no objection to my name and address being placed on the Society's computerised records.

BANKERS ORDER
To .........................................................................................Bank plc
Branch Address .....................................................................................
...............................................................................................................
Please pay The City of Rochester Society, Account No. 55101895, at the National Westminster Bank plc., Rochester (sort code 60-17-36) the sum of £ ........... now and on 1st April in each subsequent year the sum of £............ until further notice. Please cancel any previous Bankers Order to the Society.
Account Number ...................................................................................

Signature .................................................. Date ....................................