Southwick History And Preservation Society
Established October 2002
Annual Membership £5 adult, £3 youth, £10 family & group
For talks, newsletters, socials, outings, family history research, campaigns,
education etc.
Your support and help is requested to create a collection of historical memories
in a variety of formats from written word to items of everyday use.
They will be used to promote our heritage and be available
to people who have an interest and affinity with IIIII
Southwick-on-Wear.
Southwick History and Preservation Society
Tel. 0191/5659234 Email. Southwickhaps@aol.com
APPLICATION FORM
SOUTHWICK HISTORY AND
PRESERVATION SOCIETY
(SHAPS)
Application for Membership
Date:……………………Name…………....…………………………...…..
Address:....…………………………………………………………………..
…………....……………………………………………………….………..
…..…….……………………………Postcode……………………………..
E Email…………………………....…………………………...……………...
Telephone No: …………………………………………………
Fee: Full - £5: Unwaged/OAP/Youth - £3: Group/Family - £10
Please Note:
To comply with the Data Protection Act, I agree/disagree that my name and details
shall be kept on a database for the use of SHAPS (Please delete as appropriate).
Signature:……………………………………………………………….
My links with Southwick (i.e. born in, live in, family connections, etc.)
…………………………………………………...…………………………………
My interests (Family History, Local History, etc)
……………………………………………………………………………………..
Complete and return with the appropriate fee to:
The Honorary Secretary, SHAPS, c/o 13 Hampden Road, Roker, Sunderland,
Tyne and Wear, SR6 9QQ
Tel: 0191 5659234 Email us at: Southwickhaps@aol.com
SOUTHWICK HISTORY AND
PRESERVATION SOCIETY
(SHAPS)
Application for Membership
Date:……………………Name…………....…………………………...…..
Address:....…………………………………………………………………..
…………....……………………………………………………….………..
…..…….……………………………Postcode……………………………..
Email…………………………....…………………………...……………...
Telephone No: …………………………………………………
Fee: Full - £5: Unwaged/OAP/Youth - £3: Group/Family - £10
Please Note:
To comply with the Data Protection Act, I agree/disagree that my name and details
shall be kept on a database qqqqqq
for the use of SHAPS (Please delete as appropriate).
Signature:……………………………………………………………….
My links with Southwick (i.e. born in, live in, family connections, etc.)
…………………………………………………...…………………………………
My interests (Family History, Local History, etc)
……………………………………………………………………………………..
Complete and return with the appropriate fee to:
The Honorary Secretary, SHAPS, c/o 13 Hampden Road, Roker, Sunderland,
Tyne and Wear, SR6 9QQ
Tel: 0191 5659234 Email us at: Southwickhaps@aol.com