Somers Residents Association

SRA Membership Application

Resident 1

Surname : At least one resident surname is required.

First Name : At least one resident first name is required. Title : Mr Mrs Ms Dr Prof Please select a title.

Email Address :

Contact Telephone or Mobile : A contact phone number is required.Please enter a valid telephone or mobile phone number.

I am a : New Member Renewing Member
Please indicate whether you are a new member or renewing.

Resident 2

Surname :

First Name : Title : Mr Mrs Ms Dr Prof

Email Address :

Contact Telephone or Mobile :

I am a : New Member Renewing Member

Resident 3

Surname :

First Name : Title : Mr Mrs Ms Dr Prof

Email Address :

Contact Telephone or Mobile :

I am a : New Member Renewing Member

Somers Property Address

Please enter your address in Somers.

Postal Address

Please enter your postal address.
Postcode : Please enter your postcode.Please enter a valid Postcode.Please enter a valid Postcode.Please enter a valid Postcode.

Preferred Method of Communication Email Post Please tell us whether you prefer to receive updates by email or by post.
(for regular newsletters and other notices)

Residential Status
To help provide an accurate profile of members, please complete this section by selecting the option which best describes your residential status in Somers :

Permanent Resident (own home)
Holiday / Weekend Resident (own home)
Non-resident Property Owner
Tenant in Somers
Please indicate your residential status in Somers.

Payment Method (Please indicate how you will be making your subscription payment).

Electronic Transfer to the SRA Bank Account
Cheque (sent by post)
Please indicate how you will be making your subscription payment.

Thank you for filling in the membership form. Please press the "Join the SRA" button below to send your completed form to us.