Confidential
                                                    Fulshaw WI Renewal Application Form 2019
                           A COMPLETED FORM IS REQUIRED FOR ALL MEMBERS FOR 2019
Please check all your details to ensure you receive correspondence and WI mailings.  Would you spare a few moments and complete the form and enclose with your annual subscription?  Thank you.

Title:  _______First Name: ____________________ Surname: ________________________
Age Range (please circle) 18yrs - 25yrs / 26yrs – 35yrs / 36yrs – 50yrs / 50yrs – 65yrs/65yrs – 80yrs / 80yrs+ 
Home Address:__________________________________________________________________________  
Postcode:  ___________             Contact Tel. No: __________________     Mobile No:_________________ 
Full Membership  Y / N     Dual Membership  Y  / N  If you are joining as a Dual Member please indicate your first WI  ____________________________ 
In order to receive up to date monthly news and updates from Fulshaw WI and WI Life magazine, please enter your email address here (please print clearly): ___________________________________________ ___
In line with data protection and anti-spam laws we will only use your details with your express permission. When sending mailing from the Women’s Institute email address, we will ensure that your address is, wherever possible, in the BCC field. Your details can be accessed by us (your WI), other WIs you are a member of (Dual Members), your Federations and by the NFWI (collectively referred to as ‘the WI’ here).  The WI will use the details you provide in this membership form for our legitimate interests to administer your membership (and if you are an officer, a committee member or have another role, that position) as well as to send you your copy of WI Life through an external mailing house. 

We will take photographs at WI meetings/functions to be published on social media, publications and our website. Please tick if you wish your photograph to be published.     Yes  □    No  □  
If you do sign up for any open events we would like to distribute your email address to those attending for the purpose of car sharing etc.
Please tick if you wish your email to be distributed   Yes  □    No  □ 
It is against the principles of the WI for individual members to use the organisation for the promotion of a commercial interest without the approval of the committee. 

Membership Costs 
I enclose a cheque payable to Fulshaw Women’s Institute for the annual Membership fee of £42 Annual (£20.50 Dual).  Bacs payment is also available.
The renewal date for membership is January 1st each calendar year.   
Signed:___________________________  Print Name: ______________________ Date: ___________________
 
Please return to: Mrs J Palin, 31 Strawberry Lane, Wilmslow, Cheshire,   SK9 6AQ