Please complete this form and follow the instructions to pay your subscription. Choose a membership category Membership type * - Select -individual £10family (two or more at the same address) £15group with charitable aims (not-for-profit) £25corporate (minimum) £50concession (unwaged) by prior arrangement The concessionary rate has been discontinued but may be available by arrangement. Contact the Treasurer here. First Name * Surname * Other names (for Family membership) Organisation Name (if applicabile) Address * Postcode * Email (main contact) Additional email addresses (for Family membership) Contact phone number Additional information Please use the box below for additional information or any queries you may have. Please check below * I consent to the Society holding my/our personal data only in order to keep me/us informed of PHS and membership issues, and on the basis that it is not to be shared with any third parties. Payment method * Please select how you would prefer to pay your subscription online bank transfer by annual standing order by cheque Cheques should be made payable to "Potteries Heritage Society" and posted to "The Treasurer, 58 Richmond Street, Stoke-on-Trent, ST4 7EA". For online or standing orders, details will be emailed to you after you have submitted your application. Subscriptions are effective from 1st January to 31st December. Members enrolling on or after 1st July may pay half the subscription rate. Please check that you have completed all the relevent fields before clicking submit below: