Subscription Form

 

Please complete the form and send with a cheque for £5

( made payable to  Patrons of the Victoria Hall Organ) to -

 

M. Rhodes,

52 Douglas Ave.,

Oakhill,

Stoke-on-Trent,

ST4 5JZ.

(Telephone 07967 806 409)

PLEASE COMPLETE YOUR DETAILS IN CAPITALS

 

YOUR NAME ………………………………………………………..

 

YOUR ADDRESS ……………………………………………………

 

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YOUR TELEPHONE NO. …………………………………………..

 

YOUR EMAIL ADDRESS  .........................................................