Please provide the following information and then click the 'Submit' button at the bottom of the form:
Surname Forenames Title (opt.) Address Address Town or City County or State Post or Zip code Country Telephone Mobile
Please state your areas of Mortimer and Related Interests:
Data Protection:
I hereby give the Mortimer History Society permission to put the following contact details on the MHS website. I agree to contact the Membership Secretary should I wish to remove these details from the website. Please tick all that apply:
Name
Address
Telephone Number
Email Address
Areas of Mortimer Interests
Other Relevant Interests
None of the above.
The Society holds information on a central dabase. This includes response and application forms, corresspondence or other dealings with the MHS. We only use your information for administrative purposes and will not make this available to other outside organisations. You have a right to ask for a copy of your information for which we charge a small fee of £5.
Please help us keep your details updated. Any changes should be made via this form or the membership form. For any further membership information please contact the membership secretary.
