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Membership Form

The information you give us is strictly confidential and will not be passed on to other third party.

Title: (Mr/Mrs/Miss/other )
Name:
Surname:
Maiden Name:
If applicable
Address 1:
Address 2:
Area eg. Archway or Holloway or Islington
Town / City eg. London, Southampton, Manchester
Post Code:
Date of Birth:
Tel No:
Mobile No:
Fax No:
Email:
Occupation

If retired occupation before retirement
Home Town/Village in Malta
How long in the UK?

Or Year of Arrival
What is your connection with Malta: First Generation Maltese
  Second Generation Maltese
  Third Generation Maltese
  Spouse Maltese
  Associated/Friends with Maltese?
  Other
 
 

MEMBERSHIP FEE: FOR THE FIRST YEAR IS FREE

Donations to help towards the running costs of the organisation may be sent to:

Membership Secretary
Maltese Culture Movement
P.O. Box 2964
London N19 4NS

Tel: 020 7272 9000

Please make all Cheques/P.O payable to ‘MALTESE CULTURE MOVEMENT’

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