Please print off this page and complete it in clear lettering.
Send it to The Membership Secretary, B&CLHS,
154 Woodland Gardens, Isleworth TW7 6LR.

I would like to join the B&CLHS, my details are listed below.
I enclose a cheque for £9.00, made out to
‘The Brentford & Chiswick Local History Society’.

Name

Address

Phone no

Email address

Please send me the programme by email (circle yes or no below)

yes

no

Signature