The Official Leonard Nimoy Fan Club Membership Application form


OLNFC
22 PUREFOY ROAD
COVENTRY
CV3 5GL
ENGLAND


(DELETE WHICH IS NOT APPRECIABLE)                                  FULL MEMBERSHIP
                                                                  
                                                   RENEWAL


TITLE (Dr,Mr,Mrs,Ms etc)......................................................................................................

Surname / Family Name......................................................................................................


First Name / s.....................................................................................................................


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

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

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Postcode/Zip......................................................................................................................

Country..............................................................................................................................


Telephone no......................................................................................................................

Email.................................................................................................................................

Fees :        UK= £12                 REST OF WORLD INCLUDING EU=PayPal
                                                    your payment currency will be  changed to $27usd   
     

PayPal (non UK).............Cash(UK only)...........P O (UK only)...... Cheque (UK only)..........

       
Amount Enclosed.................................Sent via Paypal...............................................

SOMETIMES WE ARE ASKED TO PROVIDE FANS FOR TV/FILM/PRESS
IF YOU WOULD BE WILLING FOR YOUR CONTACT DETAILS TO BE PASSED ON TICK HERE............
THERE IS NO OBLIGATION TO DO THIS AS A CONDITION OF MEMBERSHIP,AND WE WOULD ALWAYS CONTACT YOU FIRST,
BEFORE GIVING OUT ANY PERSONAL CONTACT  INFORMATION TO THE MEDIA.
IF YOU ARE NEW TO FANDOM AND  HAVE ANY QUESTIONS
JUST INCLUDE THEM ON THE BACK OF THE FORM
3. MAKE PAYMENT
 
   UK Residents : write cheque or buy a Postal Order
                          payable to OLNFC for the value of £12
                         
  
   Non-UK resident: Make your payment using Paypal
                              by following the link  below
                            
                              Or send cash in £ /USD at your own risk.
     Please note we only accept UK Sterling or USD as cash payments
if sending cash for non uk  £16/$27

THE  OFFICIAL LEONARD NIMOY FAN CLUB
MEMBERSHIP
APPLICATION FORM
There are 4 stages to complete for membership

1. READ THE INFORMATION PAGE
2. PRINT OR COPY THE FORM BELOW
  COMPLETE  DETAILS REQUIRED CLEARLY
4.      SEND COMPLETED FORM (plus payment if required)
TO OLNFC
 
UK Residents:     
Please mail completed form plus cheque
(ensure you  sign,date and complete) or PO -£12 payable to OLNFC )

Non UK Residents:
payment by  Paypal:
please email us to tell us to expect your payment.
We still will require a completed form from you, so                            complete and mail to the address below.
Remember fail to send us the completed form and you could be        missed off the mailing list and not receive a  newsletter.                                                           
                           
If you choose to send us a cash payment in accepted  currencies        please ensure the money is not visible  when the envelope is
held to the light.
Enclose with the complete form and send to us.
This method is at your own risk, therefore we do not                         recommend you register or record as this draws attention to the       fact something of value is inside.
                           
                                        This is our address 


OLNFC
22 PUREFOY ROAD
COVENTRY
  CV3 5GL
  ENGLAND
email me