Hinckley Civic Society

         Membership form 2008/9

Name: ...................................................................................

Address: ..............................................................................

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Postcode: .........................................

Phone number: ........................................................

Email: .........................................................................................

Please print and complete this form, and send  with £10 membership (per household) to:

   Mr Greg Drozdz,

        c/o V.A.H.B.

            12 Waterloo Road,

                Hinckley,

                    Leicestershire

                        LE10 0QJ