NAME:
    Surname

 Forename/s

ADDRESS:
 Flat/Building

        Street

 Area/District

     Town/City

        County

     Post Code

       Country

PHONE: Daytime   Evening

COMMS: Fax  

    E-Mail

A1. One year's Post Subscription (£3.00 UK, £5.00 Overseas)  £
A2. One year's E-Mail Subscription (£2.00 Worldwide)*        £
B.  "Vegetarian London 2005" (£6.50 post-free for LV Subs.)  £
C.  Donation towards running expenses                        £
                                                              -------
                                                 T O T A L   £
                                                              =======
*E-Mails are sent monthly, but we reserve the right to change to
    quarterly paper mailings and adjust the expiry date accordingly.

Please complete as required:-
  I wish to receive a list of other London Vegan Subscribers
      and permit my name, address and phone number/s to be passed
      on to them.

I would like to help by:-
  Entering Diary Events**,     Writing Publications/Info Sheets,
  Running Information Stalls,  Becoming a telephone contact,
  Speaking in Public,          Giving Cookery Demonstrations,
  Doing Correspondence**,      Doing Mailing/Office Work,
  Doing DIY & Repairs,         Initiating Media Campaigns,
  Other:
(**=computer required)

I understand that unless I have ticked the subscribers list box above, none of the information on this form will be passed on to any third parties, and that I may inspect my computer record at no charge (and have it corrected, if necessary) at any reasonable time, subject to adequate notice being given.

          Signed ..............................     Date..../.../...
 

                                                                  [LVFO0111]