Association of Lipspeakers' Membership Form

Membership Form

Name:

Address:

Postcode:

Telephone:

Textphone:

Fax:

Mobile:

Email:

Occupation:

MEMBERSHIP CATEGORIES

FULL: This is open to those who have a lipspeaking qualification.

ASSOCIATE: This is open to those with an interest in lipspeaking and who subscribe to the aims and objectives of the Association.

MEMBERSHIP FEES ARE DUE ANNUALLY ON 1 JANUARY.

Please tick:

Full Member: £40.00	Associate Member: £15.00
Membership renewal:	New Member:

IF APPLYING FOR FULL MEMBERSHIP, PLEASE ATTACH A COPY OF YOUR LIPSPEAKING CERTIFICATE

Tick here if you need a receipt (please enclose an SAE):

HOW TO PAY:

By cheque:
Please make your cheque payable to Association of Lipspeakers and send it with this form to the membership secretary at the address below.

By standing order:
If you wish to pay by standing order, please complete this form and return it to the membership secretary who will send you a standing order mandate.

Mrs Beverley Roberts, Davenport Farm, Squires Lane, Tyldesley, Manchester, M29 8JF

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