Mr Dean Bagwell, Membership Secretary, Isle of Wight Family History Society

ISLE OF WIGHT FAMILY HISTORY SOCIETY

MEMBERSHIP APPLICATION

Please use block capitals for all details. When complete, please return to:

Mr Dean Bagwell, Membership Secretary, Isle of Wight Family History Society

47 The Winter Knoll, LITTLEHAMPTON, West Sussex, BN17 6NQ

Part 1: About you

First member’s Name: ______

Second member’s name: ______

Include titles (Mr/Mrs/Miss/Ms/Dr/etc) and your preferred forenames (for use in communications)

Address:______

______

Postcode or Zip Code:______

Country (if not UK) :______

Telephone Number (optional):______

Email Address:______

Have you previously been a member of the Society? YES/NO

If yes, please state membership number or approximate years:______

Part 2: Your membership choice

Please indicate your chosen category of membership:

Standard (with electronic journals) Anywhere @ £6 per annumYes/No

Classic (4 printed journals per calendar year) UK @ £12 per annum Yes/No

EU @ £15 per annumYes/No

Outside Europe @ £20 per annum Yes/No

Donation (if any):£

Each membership can be for one or two people living at the same address providing only that the second member is specified by name above.

My/our subscription for the current year will be/has been paid by:

Internet Banking / Banker’s Standing Order / PayPal / Cash / Cheque (delete as appropriate)

Cheques (sterling only) should be made payable to IWFHS. The Society’s bank account number is at Lloyds Bank Sort code: 30-97-42 account no. 00283911.A Banker’s Standing Order Form is available upon request.

Part 3: Tell us your surname interests

Surname
(no forenames) / County / Parish(es)
Or All Areas / Century / Centuries
(e.g. 17th, 18th, all)

Part 4: Your consent for us to use your information

How we use your personal information:Please note that personal information supplied on this form will be held by the Society in a computer database and only used for administration purposes.

We would like you to give your consent to our use of your personal information, as set out in our Personal Information Statement.This may include publishing members' names, postal and e-mail addresses and surname interests in quarterly journals and on the Internet as an aid to establishing contact with other researchers who may share the same interests. Email addresses will be electronically hidden on the Internet so that they are not visible to ‘spiders’ and used for SPAM purposes.

You can read this and our Data Policy at

Where you have a joint membership you must both sign. Unless you are both in agreement regarding consent we will treat this as no consent.Withholding your consent will have no effect on the benefits of membership.

Your consent may be withdrawn or changed at any time, by completing an online form or contacting the Membership Secretary.

I/we have read and understood the DPA and Personal Information Statement□

I/WE consent to my contact address being disclosed to other members□

And

My/our preferred contact method for other members is by:Email□

Post□

I/we DO NOT consent to my contact address being disclosed to other members□

Please Sign this form

This subscription is for the remainder of the current year ending 31st December - You will need to take out a new subscription, as notified in the November Journal, for your membership to continue beyond that date.

I/we understand that I/we shall receive the issues of the Isle of Wight Family History Society quarterly journal published in February, May, August and November either by post or electronically (as specified in part 2).

Signature(s):

Date: / / 20

Memformgen 2018