Membership is open to everyone
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 | |
| 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 |
|
| Signed | |
| Date of application: | |
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: In order to pay your membership fee, the following may be of help: |