(Please print)
FULL NAME/S ________________________________________________________________
________________________________________________________________
ADDRESS _______________________________________________________________
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___________________________________________________________________________________
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POST CODE
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TELEPHONE NUMBER ______________________________________________________________
EMAIL ADDRESS ______________________________________________________________
Please complete , and send with your cheque to The Treasurer, Hereford Civic Society, The Stable Cottage, Kingsthorne HR2 8AJ
OR BRING TO OUR NEXT EVENT AT THE KINDLE CENTRE.