Mr/Mrs/Miss: ___________________________________________________
Address: _______________________________________________________
______________________________________________________________
Post Code: ______________________ (BLOCK CAPITALS please)
Email Address: __________________________________________________
Single - £11.00 Double - £15.00 Full Time Student over 12 years of age - £5.00
Amount enclosed: £ __________ (renewable annually on 1st August)
Please make cheques payable to Hinckley Concordia Association
Please return this form to the Membership Secretary:
Mrs CAROLE TRIGG, 2 Winchester Drive, Burbage, Leicestershire. LE10 2BB
We may use your details for advising you of events and forthcoming productions within the Concordia Theatre by email.
If you object to us sending you this information, please tick here _____