Membership renewal form

Thank you for choosing to renew your Membership of The Natural History Museum.

Please complete the form below.

Membership Number Category

Title First name Surname

Address Postcode

 

Additional adult at the same address (except child, concession and single adult Memberships)

Title First name Surname

Family Members under 17 (adult + children and family Memberships only)

Title First name Surname Date of birth

Title First name Surname Date of birth

Title First name Surname Date of birth

Title First name Surname Date of birth

 

You can now PRINT the form and send it with your payment to :

Membership Office : The Natural History Museum, FREEPOST 10956, London SW7 5BD

I enclose a cheque made payable to The Natural History Museum
Please debit my
Card number
Security Number (last three digits of the number on your card's signature strip)
Expiry date
Cardholder's name

Signature

Date

Instruction to your bank or building society to pay Direct Debit

Name and full postal address of your bank and building society branch
To the Manager  
Address
 
Postcode
Name of account holder(s)
Bank or building society account number
Branch sort code (top right hand corner of cheque)
Originator's Identification number 754953
NHM Reference number (for office use only)
Instruction to your bank or building society
Please pay The Natural History Museum Direct Debits from the details on this instruction subject to the safeguards assured by the Direct Debit guarantee. I understand that this instruction may remain with The Natural History Museum and, if so, details will be passed electronically to my bank/building society.
Signature

Membership - A natural partnership