Post Code

Telephone Number

E-Mail Address

If you do not enter an Email address it will be assumed that you wish to receive everything by post.  You will then be contacted by letter.

Entering any of the information in this box is optional

I would like to become an individual member of the HAA because

If you are a member/associated with/official of any organisation/school/local authority/church, etc.

Then please give the following information

Name of Organisation

Type of Organisation (e.g. Voluntary,

commercial, college, local authority, etc.

Enter details, address, tel No. Email, URL, etc. of organisation,

I DECLARE THAT

I am interested in furthering the work of the Hillingdon Arts Association .

I agree to pay the Annual Subscription laid down from time to time by the Executive Committee. (For 2008/9 this is £2 for using Emails and £8 for receiving things by Post.

I am over the age of 18 yrs.

I agree to these details being entered in the Charity’s Register of Members and understand these will only be used for the purposes of the Charity.

Position Held