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Membership Form
 
Name ________________________________________________
                                                                                                  
Address ______________________________________________
 
_____________________________________________________
 
Postcode _____________             Email _____________________                                     
Phone _______________             Mobile ____________________
 
 
I / We wish to apply for the following membership of the Association.
 

 

 

 

 

 
Life member              (£150)
Family member         (£15)
Ordinary member     (£10)
Student member      (£ 5)
 
 
Signature of Applicant ___________________                   Date _____________________
 
 
 
Email : himalnepal@hotmail.com                                                     website : www.nepaleseassociation.com 
 
_________________________________________________________________________________
 
 
We would very much appreciate if you could fill in the Bank Direct Debit form attached as this will help us to avoid additional administrative work. Alternatively membership fee can be paid by cheque payable to Himalayan Yeti. Please write a cheque for Life membership.
 
 
Please return this form to the Treasurer:  Dr Yogendra Bajracharya
100 Riverbrook Road
West Timperley
Altrincham
WA14 5UL
 
 

 
For Official Use Only
 

 
 
 
The Association would like to thank you for your support by becoming a member.
 

               DIRECT DEBIT MANDATE
 
To: x_______________________­­______ Bank Plc,  x_____________________   Branch
(Please fill in your Bank’s full name and branch)
Please Pay:

 
Beneficiary’s Bank and Branch Name – Barclays Bank, Didsbury Branch
 

 
Sorting Code Number
 
20-26-20

 
Beneficiary’s Account Number
 
60771856

 
Beneficiary’s Name
Himalayan Yeti
Nepalese Association in the UK
 

 
First Payment
£15.00

 
Date of First Payment
1st August 2010
 
 

 
Usual Payment
£15.00

 
Starting Date
1st April 2011

 
Frequency
1st April of Each Year
 

                                                           

 
Account to be debited
 
x……………………….
 
 

 
Sort Code Number
 
x…………………….

 
Account Number
 
x……………………………………..

 
 
Signature(s) x________________________                  Date x ________________________
 
Please fill all boxes marked (x) and return it to the Treasurer:       Dr Yogendra Bajracharya
                                                                                                100 Riverbrook Road
                                                                                                West Timperley
                                                                                                Altricham
                                                                                                WA14  5UL