Name: Mr/Mrs/Miss/Ms/Company …………………………………………………….

Address: ……………………………….………………………………………………….......

.......……………………………………………...….… Post Code …....……..……….

Date: ………………..…….…........ Telephone: …………………………..…………

E-mail: ..… ….………..……………................….

The subscription year commences on 1 April. New subscriptions received in January, February and March are effective immediately and remain in force until 31 March the following year.

I/We wish to subscribe to Castletown Heritage in the
following category (please tick as appropriate):

• New Member .....
  or
• Subscription Renewal .....

Individual £5 _ Family (at same address) £7.50 _ Student £2 _ Corporate £50 _


In addition I/we wish to make a donation of £………………… Total £…………..


If a Corporate Subscription, please give a contact name and specify number of
Newsletters required (maximum 2 copies free):

Contact Name …………………………........…… Newsletter copies:
1 _ 2 _ (please tick option)

Please complete the standing order form below or include your payment. Send to:

Georgina Roper, Treasurer, Castletown Heritage,
25 Hope Street, Castletown, IM9 1AP, Isle of Man.

STANDING ORDER MANDATE – the preferred way to pay your subscription

Name of your bank: __________________________________________________________

Branch: _______________________________________ Sort code: ___________________

Account name(s): ______________________________Your Account no: ___________________

Instructions to your bank:

Please pay to the account of Castletown Heritage at Barclays Bank, Castletown, sort code 20-26-74, account number 30575127,

the sum of £_________

in words (___________________________pounds_____________________pence) upon receipt

and continue payments annually on 1 April until further notice.

Signed: __________________________________ Date: ___________________________

FOR OFFICE USE ONLY: When making payment, please quote reference: