Membership Form
| First Name | ____________________ | Last Name | _____________________ |
| Category | 
Individual Member
Organisations |
Concessions Others |
|
| Academic Institution | __________________________________________ |
||
| Address |
__________________________________________ __________________________________________ __________________________________________ |
||
| Telephone | _____________________ | Fax | ______________________ |
| _____________________ | |||
| It is a great help to the Society if members pay via a standing order at the beginning of each year. | |||
| Paid by Standing Order | |
||
| Total Membership Fee Enclosed | |
||
| Date | _____________________ | Signature | ______________________ |