Please help us by joining early by post.

I wish to join TPH film club for the 2010/2011 season
        Note: All members must be over the age of 16.

I enclose £..30.......................................
         (Cheques payable to Thornbury Picture House)

Please write clearly in Capital Letters.

From  (Mr, Mrs, Ms,Miss)

NAME------------------------------------------------------------

ADDRESS------------------------------------------------------

---------------------------------------------------------------------

----------------------------------------------------------------------

POSTCODE-----------------------------------------------

Telephone--------------------------------------------------

Mobile-------------------------------------------------------------

email---------------------------------------------------------------

Signed---------------------------------Date--------------------

DPA Statement. Any contact information provided will be used only in connection with Thornbury Picture House and for no other purposes.

Membership fees for 2010/11 season

£30.00 for 1 person    

Please take a copy of this page on your own printer and send the completed form with your cheque to:

TPH Membership Secretary
Hollybush Cottage, Clay Lane, Thornbury,
South Glos, BS35 3UA. Tel 01454 412272
email holly-bush@talktalk.net

Please help us by joining early by post.

I/We wish to join TPH film club for the 2010/2011 season
        Note: All members must be over the age of 16.

I/We enclose £.........................................
         (Cheques payable to Thornbury Picture House)

Please write clearly in Capital Letters.

From  (Mr, Mrs, Ms,Miss)

NAME 1------------------------------------------------------------

NAME 2 ------------------------------------------------------------

ADDRESS------------------------------------------------------

---------------------------------------------------------------------

----------------------------------------------------------------------

POSTCODE-----------------------------------------------

Telephone--------------------------------------------------

Mobile-------------------------------------------------------------

email 1 --------------------------------------------------------------

email 2 --------------------------------------------------------------

Signed---------------------------------Date--------------------

DPA Statement. Any contact information provided will be used only in connection with Thornbury Picture House and for no other purposes.

Membership fees for 2010/11 season

£30.00 for 1 person £60.00 for 2 people   

Please send the completed form with your cheque to:
TPH Membership Secretary
Hollybush Cottage, Clay Lane, Thornbury,
South Glos, BS35 3UA. Tel 01454 412272
email holly-bush@talktalk.net