DATE …………………….. MEMBERSHIP - Individual / Institution / Corporate
Title …………… Amount enclosed £
Name ………………………………………………………………..
Address …………………………………………………………………………………………………
Town ………………………………………………………………………………………………..
Postcode ………………………………………….. Email address
Country ………………………………………….. …………………………………………………
Pleases print this form and enclose a cheque for the correct membership rate made out to ‘ECOSAL UK’ to:
ECOSAL-UK WESTGATE, HAYTON, ASPATRIA, CUMBRIA CA7 2PD
Please send your application form and subscription to :
ECOSAL-UK, Company Secretary, Westgate, Hayton, Aspatria, Wigton, Cumbria CA7 2PD
All correspondence, notifications of events and newsletter will be circulated by email.
Please make cheques out to : ECOSAL-UK
or
complete a Direct Debit Form : Details to appear here.