MEMBERSHIP ENROLMENT FORM &
INVOICE
Suffolk & Essex Environmental & Energy
Group Fees for 2011/2012
Please complete &
return this form together with a cheque for the due amount based on the
following fee structure.
First Name £35.00 Individual
Name........................................................................................................................
Second
Name £17.50 Individual
Name....................................................................................................................
Third
Name £17.50 Individual
Name.......................................................................................................................
Fourth
and thereafter £00.00 Individual Name
........................................................................................................
Organization:...........................................................................................................................................................
Address:.................................................................................................................................................................
Telephone:..............................................................................................................................................................
Email:...................................................................................................................................................................
Members
to retain one copy as an invoice and the other copy to be returned with Cheques
payable to:
Suffolk & Essex Environment & Energy Group.
Return
to:
Mr R Fisk
740 Old Norwich Road,
Ipswich, Suffolk, IP1 1LG
Tick here ----- if details should be withheld from other
members.
Please return your completed form and fees by 31st August
2011.
Note: We are trying to compile a database of email addresses to
those who are willing to accept reminders in this format. If you want to receive
this way please carefully complete the section on the form.
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