the National Council
.
.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
to: the N.C.C.L.('Liberty'),
21 Tabard Street, the
London. SE1 4LA.
I wish to Join NCCL,
Name____________________________________
Address_________________________________
________________________________________
________________________________________
Postcode_____________Tel________________
Waged [ ] £20.00 individual, or [ ] £25.00 two people at one address;
Unwaged [ ] £ 6.00 individual, or [ ] £10.00 two people at one address.
[ ] I also enclose a donation of £____.___
by [ ] Cheque/PO payable NCCL, or
[ ] Access/Visa/Mastercard, number [____________________] expires [__/___/______]
signed__________________________ date ______________________
[X] Please send details of AGM in London 27and28/4/1996 (cross out if not)
[X] Please send details of any local branch in my area (cross out if not)
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Form printed from Dave<XEMU>'s web-pages.