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Gipping Valley -
Local Exchange Trading Scheme (LETS)

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Application Form

Please print this form, write clearly in block capitals and post it together with the joining fee (£5 for individuals or £10 for families, charities or businesses; please make cheques payable to "Gipping Valley LETS") to :-

        Brian Fearnley                     Tel: 01728 628181
        14 Dove Close
        Debenham
        Suffolk
        IP14 6RR

NAME _____________________________________________

ADDRESS __________________________________________

___________________________________________________

___________________________________________________

PHONE _________________________ MOBILE _________________________

E-MAIL ____________________________________________

I agree to the conditions of the Members Agreement and consent to my membership and account details being held on computer record. I also consent to the distribution of these details to Gipping Valley LETS members.

SIGNED ____________________________________________


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