Application for individual membership(please see over for Group membership)
Please select: Individual over 55□Other interested person □(over 16)
Full Name ……………………………………………………………………………………………………..Address……………………………………….……………………..………….……………………...…….
………..…….……………………………………………………………. / Postcode……………..………
E-mail…….……….…………………………………………………… / Phone.………….……………..
HSCN collects and uses the personal information on this form to:
Complete our Register of Members, which the law requires we make available in full to Trustees and, excluding contact details, to other Members
Send you information about our work and about the work of similar organisations; request your feedback on issues that are important to our work; request updates of your information, and request donations.
We use email format to reduce our costs and increase the number of communications we can send you. If you prefer to receive communications in print, please tick here. □
Signed …….……….……………………………….………..……….. / Date ……….……………….…Sending this by email to equivalent to signing and dating
Membership is free: however a donation would to help us to cover our costs:
Please enter the total amount enclosed / £…….….……Cheques should be made payable to
Highland Senior Citizens Network. / / To add Gift Aid (25%) to your donation, please confirm
Please return completed application and any donation to: / 1. You are a UK taxpayer .
2. You donated your own money (not on behalf of someone else, a group or company).
□ I agree this information is correct
Signed: …………………………………………………
H.S.C.N.
Box 301
8 Church Street
Inverness
IV1 1EA / Or email the completed form to
Thank you for ensuring your voice is heard. Your support is vital.
We will notify you once your membership is agreed by the Board under our Constitution.
Application for group membership(please see over for Individual membership)
Name of Group………………………………………………………………………………………………..Name of Person to Contact ………………………………………………………………………………
Address……………………………………….…………………………………………………………………
………..…….……..………………………………………………… / Postcode ………………………….
E-mail …….…………………………..…………………………… / Phone……….………..……………
Website……….………..………………………………………….
Main Purpose of Group
Geographic area your services cover (eg Easter Ross, or Tain)
Number of members / people participating in group activities (average)
We use email format to reduce our costs and increase the number of communications we can send you. If you prefer to receive communications in print, please tick here. □
Signed …….……….……………………………….………..……….. / Date ……….……………….…Sending this by email is equivalent to signing and dating
Membership is free: however a donation would to help us to cover our costs:
Please enter the total amount enclosed / £……..…..Cheques should be made payable to Highland Senior Citizens Network
Please return completed application and any donation to
H.S.C.N.,Box 301, 8 Church Street, Inverness, IV1 1EAor email to
Thank you for ensuring your voice is heard. Your support is vital.
We will notify you once your membership is agreed by the Board under our Constitution.
Highland Senior Citizens Network is a Scottish Charitable Incorporated Organisation no SC034260