MIC Membership: Social Club

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Application & Payment Form

Please enter your details below to become a Social Club Member of MIC. Upon submission you will be taken to PayPal to make your secure online payment of £30.00 (inc VAT). All fields required (*).

Please indicate if you are renewing your membership (*)
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Organisation
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Contact details
Title (*)
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First Name (*)
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Surname (*)
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Email Address (*)
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Tel (plus dialling code) (*)
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Fax
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Billing Address (*)
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City (*)
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Postcode (*)
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Date you would like to commence your Membership (*)
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Please read MIC Club Annual Membership Terms & Conditions, top right. I agree to the MIC Membership terms & conditions.
(*)
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By submission I confirm that I would like to become a Social Club Member of MIC for a yearly fee of £30.00 (inc VAT). You will now be taken to PayPal to make your secure online payment.