Southampton Scrapstore

About you

Your Name (required)

Your Email (required)

Your Address

Postcode:

Telephone (landline)

Telephone (mobile)

About your group/event

Your group/event name

Event membership gives you one membership card to be shared between two named individuals. Please enter the names of those individuals below (one per box).

Roughly how many people will benefit from your membership of Southampton Scrapstore?
Adults:
Children:

Final bits

How did you hear about us?
AdvertisingWord of mouthInternet searchLong-standing member

We'd like to keep you up to date with what's going on at the Scrapstore by sending you our newsletter and other occasional updates. We promise not to share your details with anyone else. Would you like to join our mailing list?
Yes pleaseNo thank you

By submitting this form, you are making the following statements:

• I am aged 18 or over
• I have read the terms and conditions of membership
• I agree to abide by the terms and conditions of membership
• I agree to the contents of this form being transmitted over the Internet and stored by Southampton Scrapstore for administrative purposes
• All the information on this form is correct to the best of my knowledge
• I agree to pay the current membership fee for the type of membership selected above.

Please confirm:
I agree to the terms above

After submitting this form, you will be directed to the PayPal website where you can securely pay for your membership using your PayPal account.