Name …………………………………………………………………………………..

Address………………………………………………………………………………..

……………………………………………………………………………………………

Post Code…………………..………..………..………..………..………..………..

Telephone Number…………………………………..………..………..………..

email……………………………………………………………………………………

 

Single membership……………………………..           £7.50

Joint membership……………………………….         £12.50

Additional member at same address……..           £5.00

Corporate membership…………………………        £30.00
(Businesses, firms, schools and colleges, etc.)

Cheques to be made payable to “Cockermouth & District  Civic Trust.

Please print off and send to:

Ian Dodsworth, Hon Treasurer,
Cockermouth  & District Civic Trust,
1 Banks Court,
Market Place,
Cockermouth,
CA13 9NG