Membership Application

Buckinghamshire Badger Group,

Please complete the details below as appropriate, then print out the form and send with the membership fee of £5 (if applicable - see below) and any further donation you wish to make to the address opposite.

If folded correctly, this form will fit a standard DL window envelope

c/o Anne Bourne,

Tho Old Workshop,

The Common, Holmer End,

High Wycombe,

HP15 6XG

THANK YOU

for supporting our work, which helps to ensure that badgers continue to thrive in Buckinghamshire.

I enclose a cheque for	£		*(cheques should be made payable to Bucks Badger Group)*
OR			I would like to pay by standing order. Please send me a mandate*

Please give us the following details:

Surname
Title

First Name

Address 1

Address 2

Address 3

Post Code

Mobile Phone

Home Phone
Work Phone

Email

If you are able to help in a practical way in running the Group, please tick below as appropriate:

recording and disposal of dead badgers manning publicity boards at outside shows

sett monitoring becoming a local contact for your area

other (please specify)
* acceptance of membership is subject to the standing order mandate being completed and returned to us

Data Protection Act 1998 - Buckinghamshire Badger Group intends to keep your membership details on computer. They will not be used for any purpose other than the efficient running of the Group. If you object to your details being held on computer you should notify such objection in writing at the time of your application for membership.

Surname		Title
First Name
Address 1
Address 2
Address 3
Post Code
Mobile Phone
Home Phone		Work Phone
Email

recording and disposal of dead badgers		manning publicity boards at outside shows
sett monitoring		becoming a local contact for your area