Brecknock Society and Museum Friends
c/o Brecknock Museum
Captain’s Walk
Brecon
Powys
LD3 7DS
Wales
BRECKNOCK SOCIETY & MUSEUM FRIENDS
APPLICATION FOR MEMBERSHIP
NAME........................................................................................................
ADDRESS .................................................................................................
...................................................................................................................
....................................................................... DATE................................
Please enclose a Cheque for £10 made out to the Brecknock Society & Museum Friends OR preferably complete the Bankers Standing Order
-----------------------------------------------------------------------
BANKERS STANDING ORDER
(Block letters please)
To.......................................................................Bank Plc
Address............................................................................
........................................................................................
Please pay to National Westminster Bank Plc, Brecon
(51-81-27) for the account of the Brecknock Society & Museum Friends (02116146) the sum of £10 Now and the sum of £10 on St Davids’ Day in each year until further notice.
Please notice that this order cancels any previous order payable to the Brecknock Society &Museum Friends.
Name(s) ..............................................................................
Account No. .......................................................................
Address .............................................................................
..................................................................Post Code.........
Signature ................................................. Date..................
(Please send this Bankers Order or cheque to Membership Secretary, c/o Brecknock Museum, Brecon, LD3 7DW, or leave forms at the Museum.
Do not send directly to your Bank.