If you are interested in joining the Noel Coward Society you can do so in a number of ways:

If you are living in the USA or Canada then please email your name, address, email address, fax and/or telephone number and how you wish to pay to Ken Starrett.
If you are living in the UK or the rest of the World you can email your name, address, email address, fax and/or telephone number and how you wish to pay to Celia Cologne.

Alternatively you can complete the form below, print it and fax it to: +44 (0) 1603 400683.
Forms can be sent by post to: NCS Membership Secretary, 3, Somerville Road, Poulner, Ringwood, BH24 1XJ, UK
Tel: 01425 478 760 email: [email protected]
NOEL COWARD SOCIETY - APPLICATION FOR MEMBERSHIP

To: Celia Cologne, NCS Membership Secretary, 3, Somerville Road, Poulner, Ringwood, BH24 1XJ, UK
Please enrol me in/ renew my membership of The Noel Coward Society for the next twelve months.

Name (in BLOCK LETTERS) ……………………………………………………….……………….

House number and street   ...................……………………………………………….……………….

Town/City  ................................……  County/State/Region  ……………………………………….

Post/Zip code ..............................  Country  …………………………………………………………

Telephone number  ……………………………………………………………………………………


RATE
I qualify for the subscription rate checked below
A Full rate of £25 for twelve months (for US residents $35)
B Reduced rate for members paying by standing order £20 ($27.50) for twelve months
C  Reduced rate for anyone undergoing full time education  £15 ($20)

I commenced my course at ……………………………………………………in the year  ………


TYPE OF PAYMENT
Please send payment by Cheque (On London bank only) or

Credit card

Type  ............……………….. Number……………………………………………………..

Expiry date  ………….   Name on card …………………………………………….……..

(Payments by credit card may be posted or sent to email address or fax number)
D Standing order (Return with completed application. Do not detach)


AUTHORITY TO PAY BY STANDING ORDER

To the Manager …………………………  Bank/Building Society  ………………………………….

Address  …………………………………………………    Post code) ………………………….…..

Account name ……………………………..     Account number …………………………………….
On receipt of this form please pay £20 to The Noel Coward Society, Sort code 30-99-98 account number 1356000 at Lloyds TSB Bank, 9. The High St.,Yeovil, Somerset, BA20 1 RN

Then £20 annually commencing the year ………. on the ……………(day) of January or July (underline your choice) until further notice and debit my/our account above.

Signed …………………………………………     Date ……………………………………………
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