Push Bikes Membership Application Form
Please enter your details in the form below. Items with underlined headings are required. Items with italic headings are very helpful (but not essential).
Print the form, sign it & post to:
PushBikes
54-57 Allison street
BIRMINGHAM B5 5TH.
Members can pay by cheque or standing order.
| Your details | |
|---|---|
| Name(s) | |
| Address | |
| Post code | |
| Home telephone | |
| Mobile telephone | |
| Work telephone | |
| Email address | |
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| Get the newsletter by email? | |
| Printing & posting the newsletter costs about 2/3 of the subscription! Getting the newsletter as a pdf by email lets subscriptions work on campaigning, saves trees..... Email my newsletter | |
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| I/we* enclose one year's subscription: | |
| Subscription | Individual, waged:
£11.00 Individual, unwaged: £5.50 Joint/Family: £14.00 |
| Voluntary donation | (optional) |
| TOTAL | |
| Signature | |
| Date | |
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| I heard about Push Bikes from | |
| I/we* would like to help by: | Letter
writing Helping on Push Bikes stall Reviewing plans Writing articles for Newsletter Leading rides Assisting with Newsletter Newsletter/leaflets distribution Newsletter stuffing Other |
