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Membership Application FormMembership for the 2019/2020 season of the Kent Health and Safety Group is ?30.00 which should be paid by the end of December 2019 ideally by BACS quoting your name/company.Bank details are Account name: Kent Health and Safety GroupSort Code: 20-54-11Account Number: 50549169Please complete this form and return it to Christine Pavey by email or post to Commercial Secretary, 19 Camellia Close, Rainham, Kent. ME8 OHJ. Tel. 01634 234561.If you wish to pay by cheque, the cheque should be made payable to Kent Health and Safety Group and sent to Christine Pavey. Please write your name or organisation on reverse of cheque.Title (Mr/Mrs/Ms/Dr/etc.): ………………………………………………...First Name: ………………………………………………...Surname: ………………………………………………...Job Title: ………………………………………………...Company: ....................................................Address Line 1 ………………………………………………...Address Line 2 ………………………………………………...Town: ………………………………………………...County: ………………………………………………...Postcode: ………………………………………………...Work Telephone Number: ………………………………………………...Home Telephone Number: ………………………………………………...Email Address: ………………………………………………...I would like to receive the minutes by email: YES /NOIf YES, they should be sent to the following address (if different to the above).…………………………………………………………………………………………..For further information contact Greg Buckley, Honorary Treasurer: Tel: 07553 734430,email: kentsafetygroup@25717595885I agree to my details being published in a KHSG Members Directory.Signed ................................................................................Signed ………………………………………….00I agree to my details being published in a KHSG Members Directory.Signed ................................................................................Signed ………………………………………….If you require a receipt, please provide a stamped self addressed envelope. ................
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