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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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

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

Please click to print this form then click Standing Order form.

How to Join

Enter your details into the form, click print and send the hard copy to:
Push Bikes
54-57 Allison street,
BIRMINGHAM B5 5TH

Members can pay by cheque or standing order.

Cheques should be made payable to "Push Bikes" - two words!

A standing order is usually simpler and you don't have to remember to send a cheque each year.
Click to go to the Standing Order form.

Enter you details into the form and print it from your browser a& send it to PushBikes.