Please print out this form, fill it in and send it to the Secretary
The Secretary,
Lodge Craigellachie
241
The Square,
Grantown on Spey,
Morayshire.
Dear Sir and Brother,
Please find a Cheque enclosed for the following
items
1.
£
For my numbers in
the 241 club
2.
£
For
241 Mark
Pennies @ £4.00 each
3.
£
For my Annual Test
Fees @ £25.00 for 2004-2005 year
4.
£
Donation
Total
amount Enclosed £
..
My Details are as follows
..
Date
. Lodge
No
..
Name
.
Address
.
.
.
Telephone No
...
E-Mail Address
|
Please strike out Non Applicable |
I am / not happy to have my details added
to the lodge email list.
Signed
..