YAMSEN membership form
Please print this page, complete the form and return the completed form with remittance to:

YAMSEN
The West Park Centre
Spen Lane
Leeds
LS16 5BE

Make cheques and postal orders payable to YAMSEN.

• If you wish to pay by standing order please tick here  [    ] and we shall send you the necessary form
• Membership runs from March to March
• Donations to YAMSEN will help us in our endeavours.
• Remittance may be by cheque, postal order or standing order; please do not send cash through the post.

Tick type of membership required

Corporate membership	£25 per annum    [     ]
Individual membership	£10 per annum    [     ]

I would like to make a donation to YAMSEN   [    ] 

I would like to receive information about :
All activities [    ]    Activities for children [    ]    Activities for adult groups [    ]

Name of individual or organisation's representative

First name_________________ Surname _________________________

Name of organisation__________________________________________

Address____________________________________________________

__________________________________________________________

Post Code___________________Tel.No__________________________

I enclose remittance of _______________Date______________________

Signed _____________________________________________________