THE FRIENDS OF OXFORD LIFELONG LEARNING MEMBERSHIP APPLICATION

Member details Title:

Name: Address: Postcode: Country: Email address: Telephone number:

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Payment details

Annual subscription £20 (payable by standing order using the form overleaf).

Additional donation with gift aid Should you wish to make a donation to the Department, please visit the following webpage where you can donate online, with gift aid if applicable: www.campaign.ox.ac.uk/continuing-education or ring: 01865 270704 to donate over the telephone.

Thank you for your generosity

THE FRIENDS OF OXFORD LIFELONG LEARNING STANDING ORDER FORM

Name of bank: Address of branch: Postcode: Account name: Account number: Bank sort code: Please pay from my account: my subscription of £20 Immediately and hereafter annually on the 1

st day of January, each year, until my further written instruction to

the University of Oxford CPD Receipts Account. Account number 30103489, sort code 20-65-20.

Signature:

Date:

To the bank – please quote “FOLL” with each payment.

Please send this completed membership form to: Rachel Green Development Officer Department for Continuing Education Rewley House 1 Wellington Square Oxford, OX1 2JA

Email: rachel.green@conted.ox.ac.uk Telephone: 01865 270290 Data protection: Information collected on this form will be held in accordance with the provisions of the Data Protection Act 1998 for the purposes of processing your application and for student administration. It will be held securely and not passed on to third parties (please see our privacy policy for further information – http://www.admin.ox.ac.uk/dataprotection/privacypolicy/)