MEMBERSHIP SUBSCRIPTION FORM

Please mail this form
and make cheques or POs payable to: National Pure Water Association

8 Harebell Close, Walnut Tree, Milton Keynes, MK7 7BA

PLEASE SUBSCRIBE NOW -- AND SEND A DONATION IF YOU CAN

Annual Membership Single . . . . . . . . . . . . . . . . . £15.00

(Renewal 1 January Family . . . . . . . . . . . . . . . . .£18
each year) Students/unwaged/OAPs. . . .£10

If you have skills that you are willing to use to assist in campaign work
please tick the appropriate box(es)

I am willing to help with:
Letter writing ______
Leaflet delivery ______
Public speaking ______
Local Branch activity ______
Other ______


Name:      ___________________________________

Address:   ___________________________________

.                ___________________________________

.               ___________________________________

Post code: _________________

Phone number: _________-________________

E-mail:     ___________________________________


Profession: ___________________________________


Signature:   ___________________________________

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