THE CHUE FOUNDATION
Membership Application Form: Personal Details Page 1 of 3
PLEASE COMPLETE IN BLOCK CAPITALS
Title:
*Surname:
*First Name:
Home Address:
*Town:
Postal Code:
*Country:
* Contact
Telephone No:
Mobile: if different
from above
Fax:
*Email:
*Website:
Please note, the details marked with an asterisk* will appear on the Chue Foundation
website, and will be used by the Chue Foundation to contact you. Should you not wish
your details to be published, please mark the undernoted box.
I I do not wish my details to be shown on the website.
Data Protection Act
To see how we use your information, please read the Data Protection Statement at
http://www.chuefoundation.com. By signing this form you are agreeing your data can be used as
described.
For membership secretary use
Welcome Add to contacts Receipt
Database updated E-group invite Handbook/Leaflets
THE CHUE FOUNDATION
Membership Application Form: Course Details Page 2 of 3
Please list details of Chue Style/Grand Master Chan courses below
School Course Title Teacher Country Date
completed
I enclose cash/ cheque payable to “The Chue Foundation” covering full payment of
£180.00*
* The membership year runs from the 1st April to the 31st March, a reduced fee of £90.00 will apply to those
who choose to join between 1st October and 31st March. Payment can also be made by Bank Transfer to:-
The Co-operative Bank Plc, P O Box 250, Skelmersdale, WN86YD. Account name: The Chue Foundation
Account Number: 65164813 Sort Code: 089299 IBAN: GB59CPBK08929965164813 BIC Code: CPBKGB22
(Please remember to allow for bank charges.)
Print Name___________________________________ Signature____________________________________
Date ____________________________
Please complete all 3 forms and return with payment/advice of bank transfer to:-
Sheila Duffy
The Chue Foundation
Membership Secretary
57 Riccarton Mains Road
Edinburgh EH14 5NF
SCOTLAND
E-mail - membership@chuechanfengshui.org
THE CHUE FOUNDATION
Membership Application Form: General Page 3 of 3
Other qualification / Interests / Skills
Hobbies
List what you would like most out of membership of the Foundation (in order of importance)
1.
2.
3.
4.
5.
6.
7.
8.
Are there any specific ways that you would like to be involved in the Foundation if possible?