MEMBERSHIP APPLICATION FORM
(Single person: £12.50 Couple: £17.50)

NAME(S.......................................................................................................................................

ADDRESS....................................................................................................................................

POST CODE.......................................................Tel. No................................................................

Email address..............................................................................................................................

I would like my details to be included on the next membership list Yes / No

How did you hear about us?..............................................Approx. acreage.....................................

Livestock/crops/activities..............................................................................................................

...................................................................................................................................................
Any skills/experience etc which might be of use to others.................................................................

..................................................................................................................................................

I would be interested in attending any training courses on...............................................................

Thank you for taking the time to complete this form

PLEASE :
Enclose a cheque for £ ........... for your subscription to The Smallholders Association

If you wish to pay by standing order in the future. please ask the membership secretary for details

GIFT AID IT : As long as you are a UK taxpayer, SHA can reclaim tax on your donations at no extra cost

to you. Please indicate whether you wish SHA to claim Gift Aid on all donations you have made until further

notice. Yes / No

Your signature: ................................................................. Date:...............................................

Please return to the Membership Secretary :- Mrs Ann Parkhouse,
Fosse House Farm, Lydford on Fosse, Somerton, Somerset TA11 7DW