Membership Number

Full Name

Address

Post Code

Country

Telephone

Email

I wish to renew my membership of the London & North Western Railway Society up to 31^st December 2005. I agree to details of my membership being processed by computer for the purposes of membership administration as defined in the Data Protection Act 1998 - the data supplied on the membership form may be disclosed to other members of the Society, but will not be disclosed outside of the Society.

Signed

Date

Age
(if under 18)

I enclose a Cheque/Postal Order for £20 subscription (Overseas members outside Europe please add £5 for surface mail or £10 for airmail, all in sterling if possible). Remittances should be made payable to the “L & N W R Society”.