British Jigsaw Puzzle Library Application Form for Membership

The British Jigsaw Puzzle Library Application Form for Membership Please print and return completed forms to : Dave Cooper, Clarendon, Parsonage Road, Herne Bay, Kent, CT6 5TA Please make cheques payable to The British Jigsaw Puzzle Library

Name Of Member (PLEASE COMPLETE IN BLOCK CAPITALS)
Last Name	_________________________
First Name	_________________________
Title	_________________________
Address	_________________________
	_________________________
	_________________________
Postcode	_________________________
Phone Number	_________________________
Billing Address if different to above (PLEASE COMPLETE IN BLOCK CAPITALS)
Last Name	_________________________
First Name	_________________________
Title	_________________________		Membership	o
Address	_________________________		Postage	o
	_________________________
	_________________________
Postcode	_________________________
Phone Number	_________________________

Membership Fees (PLEASE TICK REQUIRED MEMBERSHIP)
Annual	Ł105	o
6 Months	Ł64	o
3 Months	Ł42	o
Please make cheques payable to The British Jigsaw Puzzle Library

Puzzle Details

Interlocking	o	Non Interlocking	o
Semi Interlocking	o	Any	o
Please let us know if your board size or preferences change.

I agree to abide by the rules and conditions of the Library

I enclose a cheque for membership fees
Signature	_________________________	Date	____________