Association of Lighthouse Keepers

Membership Application Form

PLEASE PRINT
Name:  
Additional members (Joint):  
Address:  
   
   
   
Postcode/zip:  
Country:  
Tel:  
Email:  
Date of birth (if under 16):   In full time education? Yes/No
Is this a gift membership?
Yes/No
Date needed by?  
Gift to be sent on behalf of  
Reason for gift?  
For ALK information only, please indicate if you are or were:
  Lighthouse Keeper
  Lightvessel Crew
  Lighthouse Service Personnel
 Type of membership requested:
I enclose remittance for * £
I also enclose a donation of    £
Total enclosed

£

Cash, Cheque or by Direct Transfer
Cheques payable to Association of Lighthouse Keepers

Signed  
Date of application:  

Please also complete the Gift Aid form if you are a UK Taxpayer

Data Protection: Your information is collected solely for ALK purposes and is not passed on to interested parties. Occasionally we may wish to send you email updates which may be of interest. Please indicate if you do not wish to receive these.

* If you wish to pay subsequent renewals by standing order, please contact the Membership Secretary or Treasurer to request a copy of the Standing Order Form.

Please complete the application form and forward it with your remittance to:
Dinah Le May, ALK Membership Secretary, PO Box 426, Lymington, Hants SO41 1DZ

In order to pay your membership fee, the following may be of help:
IBAN GB88 BARC 2033 8310 5155 23, SWIFTBIC BARC GB22