THE DISCOVERY AWARD(England & Wales)

an achievement award for people over 50


5 YEAR GOLD HOLDERS’ MEMBERSHIP APPLICATION/RENEWAL FORM

*I WISH TO APPLY FOR 5YR MEMBERSHIP /I WISH TO RENEW MY 5YR MEMBERSHIP

(Please delete as applicable)


Name ...............................................     Title..............  Mem No ..............


Address          ..................................................

 
..................................................................


Post code........................  

Telephone...............................   E-mail ..................................

If you know your 5yr Membership No. please include.................
Your details will be stored electronically by The Discovery Award .

 
I finished my Gold Award on------------------------------------------

 
(Complete if applicable) I was part of.................................group

Please do not/  send my mailings to my Group Leader ( delete as applicable)
.
Signed: ………………………………............Date ...........................


5 year Gold Membership Fee is £12.00 for which I will receive Newsletters, relevant mailings and the opportunity to attend the Annual Gatherings for 5 years.
I enclose my cheque for £12.00, made payable to The Discovery Award.
 

Please return to:  Discovery Award Membership  
                 74 Stevens Road, Stourbridge, West Midlands   DY9 0XW