Dear Member,

							          CHOLSEY & WALLINGFORD RAILWAY
          PRESERVATION SOCIETY
           A Company Limited by Guarantee but not having a share capital
           Registered Charity No. 295279       Registered Company No. 1927652


                             APPLICATION FOR MEMBERSHIP

YOUR DETAILS (Please print clearly. Items marked * are optional but may help if we need to contact you)
Title :_________ Surname :___________________________First Name/Initials:_______________
Address :________________________________________________________________________
Post Town :_____________________ County :____________________ Postcode :____________
*Telephone No. :____________________                                    *Mobile Telephone No. :__________________
*E-mail Address :__________________________________________________________________

MEMBERSHIP CATEGORY APPLIED FOR (Please tick relevant box)

Life Membership                                                        £180.00          or, by three instalments of £60
Life Membership (over 60 on date of application)                       £ 90.00          or, by three instalments of £30
Annual Full Membership                                                 £ 12.50
Annual Senior Membership                                               £ 6.00
Annual Partners Membership (2 adults under 60)                         £ 16.00          Name of Partner (Title,Initial/s,Surname)
Annual Senior Partners Membership (2 adults over 60)                   £ 8.00
Annual Family Membership (2 Adults + 3 Children)                       £ 20.00
Annual Junior Membership (Under 16)                                    £ 6.00           Age :_____
Annual Corporate Membership                                            £ 20.00
Donation to Station Appeal or General Funds                            £
TOTAL AMOUNT ENCLOSED                                                  £
I apply for membership of the Cholsey & Wallingford Railway Preservation Society (hereinafter called The Charity). I understand that in the
event of the Charity being wound up during my membership, I may be called upon to contribute a sum not exceeding one pound towards
costs and expenses of such a procedure, in accordance with the memorandum and articles of association of the Charity.


Signature of Applicant :__________________________                                        Date :________________

Signature of Parent/ Guardian (For applicants under 16 years of age) :________________________________
_________________________________________________________________________________



If you pay Income Tax or Capital Gains Tax the Charity can claim an extra 28pence for every pound
of your membership fee or donation, at no cost to you. Simply sign the declaration below.

I am a UK Taxpayer. From the date of this declaration, until such time that I inform you otherwise,
please treat my subscription and/or donation to The Charity as a Gift Aid donation.


Signature ___________________________________                                   Date _______________

Please post your completed application form together with a Cheque or Postal Order (made payable to
C&WRPS) to: The Membership Secretary, Cholsey & Wallingford Railway PS, 5 Hithercroft Road,
Wallingford, Oxon, OX10 9GQ.

                                                            THANK YOU.



                                    MEMBER OF THE HERITAGE RAILWAY ASSOCIATION

                             Registered Office: 7 ST. MARTIN’S STREET WALLINGFORD OXON OX10 0AN