I wish to become a member of the Canal Museum Trust and agree to abide by its constitution. I am sympathetic to its objectives.
Name: ______________________________________________________________________________
Address: ____________________________________________________________________________
________________________________________________________ Postcode: ___________________
E-mail: _____________________________________________ Telephone: ________________________
> I enclose my annual subscription, (cheques etc. payable to Canal Museum Trust) as follows:
Signed: __________________________
Send to: The Secretary, Canal Museum Trust 12-14, New Wharf Road, London N1 9RT
Registered Charity No. 277484