Name ______________________________

Address __________________________________

__________________________________

__________________________________

Tel. Number ______________________________

(Indicate day, date, venue, places, cost)

Cheque total £__________ payable to Black Country Society

(price includes items where stated in individual programmes)

Please Note

Any directions will be issued with receipt/confirmation, non-smoking coaches have been booked.

Indicate preference of pick-up point:
Savacentre Oldbury
Dudley
BCS membership number _________

Remember - one cheque for Summer Programme Bookings. DO remember to enclose a SAE...if you want a reply. Do not include any subscriptions/fees with Summer Programme bookings

Please post completed form, cheque and SAE to:

The Black Country Society, Summer Programme, PO Box 71, Kingswinford DY6 9YN