Wayland House High Street Watton Norfolk IP25 6AR

Secretary: Heather Nunn

07979 264074 or 01760 440837

heather.nunn@paston.co.uk

    MEMBERSHIP APPLICATION FORM

I/We apply for membership of the Wayland Chamber of Commerce and enclose a a completed Standing Order Mandate (preferred - see below) or cheque payable to Wayland Chamber of Commerce with respect to the subscription (£25.00pa).

BLOCK CAPITALS PLEASE

Name of Business: ............................................................................................................

Address of Business: ........................................................................................................

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

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

......... ..................................................................Postcode.................................................

Description of Business: ...................................................................................................

Contact Details (for publication):

Landline: .............................  ....Mobile:  .................................. .Fax: ...............................

Email: ............................................................. Website: ....................................................

I/We also belong to: (note relevant trade, professional or similar associations):

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

Contact Name: ...................................................................................................................

  [Who is the Owner / Proprietor / Local Manager / other:  . . . . . .

Signed: .............................................                                 Date: .......................  

Notes:  The Secretary of the Chamber can accept and action membership applications immediately but subject to formal approval at a committee or general meeting of the Chamber. Acceptance may be deferred to such meetings, and applications can be refused without assigning a reason. (A refusal is rare, and never because of 'competition').

A banker's standing order is the preferred means of payment for annual subscriptions as it obviates difficulties with renewals at the time the annual Directory is produced. We can supply an SO proforma on application.

The initial subscription also acts as a joining fee, thus, regardless of the date of joining, the annual subscription becomes due at a common renewal date, currently 31 December. Provision of the details above authorises the Chamber to hold them on paper and electronically, and to publish or otherwise use them but only for the purposes of business information and promotion in accordance with the Chamber's aims. Data is held and handled in accordance with the Data Protection Act.

ADVICE: DO NOT SEND MANDATE BY EMAIL - DOWNLOAD & POST OR DELIVER WHEN COMPLETED

                                              STANDING ORDER MANDATE

 To:      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     (Please write name &
            . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     FULL address of your bank)
           . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        Sort Code    . .   :  . .  :   . .

 Please pay to the account of the Wayland Chamber of Commerce at
    Barclays Bank plc (Watton Branch, East Dereham Group),
    34 Market Place, Dereham, Norfolk, NR19 2AS.

    Sort Code 20-28-20, account number 10932515, the sum of:

            £25.00 (Twenty Five Pounds) NOW            and
            £25.00 (Twenty Five Pounds) on 1^st January annually thereafter

      Reference: Wayland Chamber Membership Subscription

      Please Debit my/our Account:

     Account Name  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . .
     Account Number          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 I/we further authorise you to amend the amount specified in this instruction when
  notified by the payee of any changes to the annual subscription as may be
  determined by an annual or extraordinary general meeting of the Chamber for
  which the payee provides a copy of signed minutes.

 Signed: . . . . . . . . . . . . . . . . . . . .  . . . . . . .                       Dated: . . . . . . . . . . .

                . . . . . . . . . . . . . . . . . . . . . . . . . . .
  (Account Authorised Signatory/ies)

  IMPORTANT:  When completed, this form should be returned to:
    The Secretary, Wayland Chamber of Commerce, Wayland House,
    High Street, Watton, Norfolk IP25 6AR
  who will forward it to the bank named.
                                                                   [CoT Use:  Date Rcvd:            Fwd: Hand/Post on        ]