Computer ◆ Conservation ◆ Society

Member Resignation Request Form

In order to guard against malicious third parties (and rouge computer processes) sending in “spoof” changes to your records, we ask you to fill in as many as possible of the details which we hold for you. Don’t worry if you don’t get the details exactly right, our validation is a manual process and common sense will be applied. Please supply at least Forename, Surname and Email Address.

Please complete the form below as fully as you can and press the Submit button when it’s complete.

It would be helpful to us if you would indicate why you are resigning in the box below.

Please complete the form below as fully as you can and press the Submit button when it’s complete.

In case of difficulty please contact our membership secretary, Dave Goodwin.

Surname
Forenames
Usual Name (if different from forename)
Title
Date of Birth (optional)
House Name
No and Road Name
District
Post Town
County
PostCode
Country
Contact Telephone No.
Email Address

Reason for Resigning   

Information on this form will be sent to the CCS Membership Secretary, and you will be removed from a mailing list which is maintained by the BCS.
Your information will not be passed to any other third party.