Application Form

Please print out the following application form.
Full Name (s) Include title Mr/Mrs/Miss/etc
________________________________________________________
________________________________________________________
________________________________________________________
Note: Only one address per household membership. Please state names of all persons to be included in membership. State age if under 18.
Address
________________________________________________________
________________________________________________________
________________________________________________________
Postcode________________________________________________
Email Address____________________________________________
If your name is not Sutherland, Oliphant,Federith, Mowat, Cheyne, Keith or Gray please state your connection with or interest in Clan Sutherland in Scotland
________________________________________________________
________________________________________________________

I enclose the sum of ____________in payment of the annual/life subscription rates.
Visa / Mastercard (NOT American Express)_________________________
Card Number ________________________________________________
Name on Card _______________________________________________
Expiry Date __________________________________________________
Note: rates are in £ Sterling.-
Subscription Rates UK Overseas
Individual Life Membership £300 £400
Individual 1 year Membership £15 £20
Under 18 years old, 1 Year Membership £10 £12
Family at one Address, 1 Year Membership £22 £28

Please send your completed application form to -

The Membership Secretary

Clan Sutherland Society in Scotland

c/o 71 Old Evanton Road

DINGWALL

Ross-shire, IV15 9RB

                              SCOTLAND                                     

 

If you have a problem printing this page please email us and we will send it to you as an email attachment.   One simple way to print it is to open your office file (i.e. Microsoft Word) and simple COPY this page and PASTE it onto the new opened document and print it from that.   You could then SAVE it and print more copies to pass of to FRIENDS and FAMILIES!    If you still have problems then email us and we will send you a printed copy by post.   Email : info@clansutherland.org.uk

 

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