DEKLARACJA

The Polish Social and Educational Society
5, Parkgrove Terrace, Glasgow G3 7SD
Dom Polski im Gen. wl Sikorskiego
General Wl. Sikorski's Memorial House
Phone 0141 339 1368
Scottish Charitable Incorporated Organisation Reg. No. SC046143

Category applied for
Guide: Ordinary is for Polish nationals and their spouse or direct relatives. Associate is for all other nationalities
All Members Guide: You MUST complete name and address (including post code). Completing as much of the other information will be helpful to us.
Title (Mr, Mrs, Ms..)    
Forename(s)
Surname
Address
 
Post code
Phone
e-mail
Occupation
Date of birth
 Guide: eg 21/10/1924
     
Applicants must be aged 18 or over
Guide: You are required to sign the following general agreement before approval of membership
If admitted, I agree to comply with the rules and regulations as stated in the constitution of the Society, as well as the rulings of the Board of Trustees. Please read our Privacy Notice found on our website or by asking a committee member for a copy. I agree to my details being stored as described in the Privacy Notice.
Signature

Date

Proposer		      
Guide: You are required to supply the names of ONE proposer from ourORDINARY members. Alternatively, speak to a member of staff who can propose your application instead, Membership will be considered by our committee at the next monthly committee meeting.
Print the name of your proposer (or member of staff) below.

Proposer or member of staff

  
Guide: Once you have completed the application you can simply print it out <ctrl P> (as laid out on screen) and bring the form with you on your next visit to our Society. You must also pay the subscription fee before we can consider your application (post applicants must send a cheque with this form to us for the appropriate amount payable to "The Polish Social & Educational Society" with your name and address clearly written on the back). Your application will be considered at the next monthly committee meeting.
Office use only
Approved
  
Sec. signature
   
 
Date
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