The Exakta Circle

Application for Membership or Renewal

1 April 2010 to 31 March 2011

Renewals: make the correct payment and mention your membership number

New and returning members: print this form and send it by post to

Chris A. Fransella ARPS, 154 Forest Road, Torquay, Devon TQ1 4JZ, UK

or e-mail the information we need (see below) to secretary@exaktacircle.org

                                            Surname                                                            Forename(s)

                                            Full postal address

                                            Style (Mr, Mrs, etc)                                           E-mail address

                            Telephone No                                                    Mobile phone No

                                            Membership No (if renewing)                           Date

Put an X before the item you DON’T want

to be published in the membership list or elsewhere.

NB For 2010/11 the less colour option is no longer available

 UK £ 23, Overseas £ 25.
or € 28 by bank. (see below)

Methods of payment

PayPal to cafransella@talktalk.net

Cash

Sterling cheque or British postal order (payable to Exakta Circle)

If you live in the Eurozone and can't or won't use PayPal, you can pay € 28 to

BIC ABNANL2A IBAN NL59ABNA0550716416 H.D. Ruys Hilversum