Oriental Bird Club subscription form (credit card payment by post)

Name of member:

Address/postcode:

Email address:

Select membership category:

• Individual membership: £15
• Family membership: £20
• Libraries/Academic institutions: £25
• Business Supporting membership: £45
• Supporting membership: £25

Subscriptions run from 1 January each year. Which year is subscription to start?.....

Subscription is to run for how many years?.....

Total amount payable:........

Please enter credit card details:

• Cardholder's name (as it appears on card):
  Cardholder's address (if different from above):
  
  
  Mastercard/Eurocard, Visa/Electron, or Solo/Maestro (please specify)
  Card number:
  Card verification number (last three digits of number printed on signature strip of card):
  Expiry date:
  Cardholder's signature:

Please print the form and send completed to:
Oriental Bird Club, P.O.Box 324, Bedford, MK42 0WG, United Kingdom.