Application form to join the Hilliard Society of Miniaturists
Full Exhibiting or Friend Member

NB: We are able to accept only sterling cheques, debit or credit cards in payment of fees. Prospective members MUST have either a sterling bank account, or a MAESTRO or SWTICH debit card, or a VISA or MASTERCARD credit card.

More information about the Society

Please print this form, complete it, and post it with your subscription fee to:

The Hilliard Society
Priory Lodge
7, Priory Road
Wells, Somerset BA5 1SR, UK
Tel: +44 1749 674472

Or pay by credit card, complete your card details, sign this form, print it off and post it to the address above:

You may e-mail your card details, but please send card number, name, security code and expiry date in three separate messages

Name : (Mr/Mrs/Ms) ....................................................................

Address : ........................................................................................

...................................................................................................

Town/City:...............................County/State/Province....................................

Zip/Postal code .......................Country.......................................

Tel. No ..........................e-mail address.........................................

Annual subscription fees:

• Full Exhibiting Member ....UK/Overseas £40
• Friend Member..........UK £25 : Overseas £30

NB: PLEASE NOTE WE ARE UNABLE TO ACCEPT ANY CURRENCY OTHER THAN STERLING.

.....I enclose a cheque/P.O/Money order for £.......

.....I wish to pay the sum of £.......by VISA/MasterCard

(please delete as appropriate): We regret we can take only VISA or MasterCard

Card No. /___/___/___/___/ /___/___/___/___/ /___/___/___/___/ /___/___/___/___/

Expiry Date:____/____    Security code [next to signature on back of card]_________

Signature .......................................Today's Date: ...../...../......