Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

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Payment method *

Please select one option below. If you are paying by BACS transfer please make payment using the following details: Account Name: FRIENDS OF READING MUSEUM Bank: Metro Bank sort code: 23-05-80 Account: 30380002 Reference: Surname and first initial If you wish to pay by cheque please make payable to Friends of Reading Museum and post to: Friends of Reading Museum (FoRM) c/o Reading Museum and Town Hall The Town Hall Blagrave Street Reading RG1 1QH

Bank Transfer

Cheque