Print out this page, fill out the relevant details and send it to:
Rose’s (web), PO Box 186, Barnsley S73 0YT, England
Section 1: Information for our Membership Lists (leave blank if you don't want to be included)
Membership Name: . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . .
(assumed female name or otherwise by which you wish to be known. Don't put real
name here unless you want it to be published.)
Partners name: . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . .
(if you have a partner who wishes to participate and have her name appear in
Membership Lists)
Locality: . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . .
(town or nearest large town / county / country)
Please indicate if we may forward mail to you from other members (your address
will not be passed on). YES / NO
Section 2: Name and Address for mail to you (THIS WILL NOT BE PUBLISHED WITHOUT YOUR CONSENT)
Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County/Country: . . . . . . . . . . . . . . . . . . . . . Post/Zip code: . . . . . . . . . .
Country: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
| Section 3: Subscription and magazine details | Amount enclosed |
| Repartee subscription starting from issue number . . . . . (if you don't specify a number we will start your subscription with the next issue) |
£/$ . . . . . . . |
| New UK subscribers will receive the current issue free or please state back issue you would like if you have the current issue . . . . . |
FREE |
| Rose’s Xtra subscription (you can only have this if you also take out a Repartee subscription) | £/$ . . . . . . . |
|
Total:
|
£/$. . . . . . . |
Payments should be in UK or US currency only. Cheques must be drawn from a
UK bank.
If you send payment by a cheque/PO please make it payable to Rose’s.
We do not recommend sending payment by cash but if you do so it must be entirely
at your own risk.
For payments by credit cards we can accept the following cards: Mastercard,
Visa, Delta, Switch, Solo.
Credit card number: . . . . . . . / . . . . . . . / . . . . . . . / . . . . . . .
Issue No. . . . . . . . (For Switch/Solo cards) Expiry: . . . . / . . . .
Declaration: (applications are not eligible unless this is signed)
I declare that I am aged over 18 and have no objection to any details on this form being held on computer that will only be accessible to Rose’s personnel. Also I will respect the confidentiality of all members of Rose’s.
Signed . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . . . . . . . .