Membership form

I want to join Evolution.

Name: ___________________________________

Badge Name: _____________________________ 
(If different)
           
Postal
Address:  _______________________________

          _______________________________

          _______________________________

          _______________________________
               
          _______________________________

Post Code: ______________________________

Telephone: ______________________________

email address: __________________________
 
I do not mind having my details held on computer

I enclose £___  for: 

___ attending memberships at £24 each. 

___ supporting memberships at £14 each. 

___ child memberships (5-14 years old at the Convention) at £14 each. 

___ mascots of all kinds at £5 each.

(make cheques payable to "Evolution")

Now send this to:

Evolution,
13 Lindfield Gardens,
Hampstead,
London
NW3 6PX
United Kingdom

For information via electronic mail contact