The Rolls-Royce Heritage Trust Membership RENEWAL Title …………..…. Preferred Forename ………………...............................................…………………………………… Initials …………... Surname ……………………………….………………………………………………………………….. Address ……………………………………………………………….…………………………………………………………... ……………………………………………………………………………..… Post Code ……………………………..……..… Internal Mail Code (if applicable) .......................……….. Daytime Tel No …………….………………………………….… Email ……………………………………………………………………………………………………………………………….. Membership Fee Individual Annual Membership £8* Ten Year Membership £80 Five Year Membership £40 Branch to Which You Wish to be Affiliated (optional) Branches may periodically choose to issue correspondence at a local level, where members can find out about volunteering opportunities, lectures, events and branch activities. If you wish to receive branch specific information, which isn’t detailed in The Journal of The Rolls-Royce Heritage Trust, please indicate your branch preference(s) below: Bristol Derby & Hucknall Coventry Scottish Please tick this box if you are happy to receive branch communications by email. Data Protection The information you provide will be used solely by The Rolls-Royce Heritage Trust to maintain membership records and to provide you with services and information about The Trust. Your data will not be sold to, or shared with, any third party organisations. By mail: Complete the application form and send it, together with your remittance, to The Rolls-Royce Heritage Trust (LAF), PO Box 31, Derby, DE24 8BJ By email: Complete the application form** and email to heritage.trust@rolls-royce.com By PayPal: Make payment to heritage.trust@rolls-royce.com, detailing your requirements By phone: Call the Heritage Trust office on (01332) 241290 (overseas 00 44 1332 241290) Payments (in Sterling only) Cheques and money orders should be made payable to The Rolls-Royce Heritage Trust. Card DEBIT / CREDIT / AMEX** Card Number ……………………………………………………………………………………………………………………… Card valid from …………………… Card expiry date …………………… Issue No (if applicable) ………… 3 digit security code …………………………. (last three digits found on the signature strip on the reverse of the card) Card holder’s name and initials ……………………………………………………..……….. (as they appear on the card) * Should you wish to pay by Standing Order please contact the Heritage Trust office ** Do not send card details by email as we cannot accept any responsibility for misuse of your details by third parties and we are prevented from processing such transactions by our card service provider The Rolls-Royce Heritage Trust Company Limited by Guarantee Company Number:05979619 Registered in England. Registered office :Moor Lane, Derby DE24 8BJ Last updated: 14/09/2017