MANCHESTER CIRCLE OF MAGICIANS

To: Derek Lever, 32, Pilling Lane, Preesall, Poulton-Le-Fylde, Lancs., FY6 OEU

 

Name ...........................................................................

Address ........................................................................

......................................................................................

......................................................................................

 

Phone number:............................................... Fax number:...................................

E.mail address............................................................

 

*I am seriously interested in magic.

*I enclose my £12.00 membership fee made payable to 'Manchester Circle of Magicians'

 

 

If you wish to pay by Visa or Mastercard Credit Card (not Switch Cards) please complete the following:

Name on Card.......................... Credit Card Number.........................................

Expiry Date......................... Address ........................................................

...................................................................................................................

I agree to pay £12.00 membership fee via the above Credit Card.

We only accept Credit Cards for £24.00 or over.

Signed...........................................

 

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