Arbeia Society Application form

Mr/Ms/other:_____________________________________________

Name: _________________________________________________

Address: _______________________________________________

_______________________________________________________

Postcode: _______________________________________________

Tel: ____________________________________________________

Type of membership (please circle):

I have enclosed £……………. made payable to ‘The Arbeia Society’.

I am aware my details will be held on a database, to be used solely by Society officers.

Signed: ______________________

Date: ________________________

Please send the completed form to:
The Secretary, The Arbeia Society, Arbeia Roman Fort, Baring Street, South Shields, Tyne & Wear, NE33 2BB
Tel: (0191) 454 4093