Application for Membership.

I, (full name)  
  [maiden name  ] ,
having attended Palmer's School/College from: to:
apply for Membership of the Old Palmerians' Association.  
  
The Executive Committee reserve the right to refuse membership at their discretion.

House number /road:  
Town / City:  
County: 
Postcode:  
Telephone:  
Email:  
 
My email address may be shown on the Old Palmerians' Web Site.
 
 
Message:  
 
 
Payment Details
Payment Type:   Cheque Standing Order Direct Debit

Once your application has been processed, you will receive an email
informing you of the address to send your cheque or payment instructions to.

If you have elected to pay by Standing Order or DIrect Debit please click here
to view and print the associated form.