THE ROYAL INSTITUTION OF SOUTH WALES
APPLICATION FOR MEMBERSHIP
please use block capitals
Full Name(s) ..............................................................................
.....................................................................................................
Profession/Occupation ................................................................
Address ...........................................................................................
.......................................................................................................
......................................................................................................
Signature ................................................ Date..........................
This form, with your subscription or the completed Banker’s Order, should be sent to the Membership Secretary, The Royal Institution of South Wales, c/o Swansea Museum, Victoria Road, Swansea SA1 1SN.
Subscription
Individual £10 p.a.
Double (same address) £15 p.a..
The membership year begins on 1st June
The R.I.S.W. is a Company limited by guarantee and a Registered Charity
THE ROYAL INSTITUTION FOR SOUTH WALES
(Registered Charity No 218306)
BANKER’‘S ORDER FORM
To ......................................................................(Bank)
............................................................................(Branch)
...........................................................................(Address)
.........................................................................................
Please pay Lloyd’s Bank plc. Swansea, Sort code
30-95-46 for the credit of The Royal Institution of South Wales, account no.
2647060 the sum of
£..................................on ................................(date)
and on 1st June in each subsequent year until you receive further notice
from me/us in writing and debit my/our account accordingly. Please cancel any
previous banker’s orders issued by me in favour of the Royal Institution
of South Wales
Name..................................................................................................................
Account to be debited.........................................................................................
Account No........................................................................................................
Signature(s).........................................................................................................
Date.................................................................................
This form, when completed, should be sent to the Membership Secretary, The Royal
Institution of South Wales, c/o Swansea Museum, Victoria Road, Swansea SA1 1SN.
GIFT AID
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