GMI Membership & SO Form

GMI Membership Application Form

The G.M.I. is dependent on your membership fees to survive. Please complete all questions.
Member's Name

First NameLast Name
Address

Address Line 1

Address Line 2

Post TownRegion

Post CodeCountry
E-mail
Land Line Number

Area CodePhone Number
Mobile Number
Format: 07000000000.
Membership Type
Please select
Please join the monthly Prize Draw
Make an additional monthly donation?

Other
Subtotal Membership
Subtotal Prize Draw
Subtotal Donation
Total Monthly Donation
£/month
Gift Aid Declaration
Standing Order instructions to your bank
Name of Bank / Building Society
Account Name
Sort Code
Account Number
Monthly Standing Order to Start On

DayMonthYear
Standing Order Confirmation
Comments
Should be Empty:

GMI Membership Application Form