Cornish Dahlia Society Membership Form

Cornish Dahlia Society - Membership Application
Type of Membership Application

New MemberMembership Renewal
Membership Options
prevnext( X )
Single Membership£4.00

Joint Membership (living at the same address)£5.00

Single Membership (under 16)£4.00

Group Membership£5.00

Total £0.00
Payment Method*

Credit / Debit CardDirect DebitCheque (please see below for details of where to send your cheque)
Members Name*

TitleFirst NameLast Name
Second Members Name

TitleFirst NameLast Name
Parent / Guardians Name

TitleFirst NameLast Name
Home Address*

Street Address

Street Address Line 2

CityCounty

Post CodeCountry
Landline Contact Number
Mobile Contact Number
E-mail Address
By submitting this form you are applying for membership of the Cornish Dahlia Society. You understand that the information you provide in this form will be used solely for managing your membership of the Cornish Dahlia Society. The society has a Data Privacy Policy which is available on request. Your data will be stored and used in accordance with this Policy.

The society will use your address and telephone number to contact you regarding your membership.
Data Protection

The society may arrange for photographs/videos to be taken of shows and activities and published on our website, social media channels or the press in order to promote the society. If you consent to your image being used by the society in this way please tick this box.The society would like to communicate with you by email when possible in order to save postage costs. If you have provided your email address above and you consent to the society contacting you by email please tick this box.
Enter the message as it's shown*
If you experience any issues with completing this form or have any additional questions then please do not hesitate to contact us. Please see our website www.dahlia-cds.co.uk

If you would like to pay by cheque then please print this form, once completed, and send with your cheque (made payable to Cornish Dahlia Society) to: Cornish Dahlia Society, 3 Foxdown Manor, Wadebridge, PL27 6BD.
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Cornish Dahlia Society - Membership Application