Application Form

Please enter your details on this screen, and then print off the page.
No data is sent over the internet.

Title:	Mr Mrs Miss Ms Other (please specify)
First Name:
Surname:
Address 1:
2:
3:
Post Code:
Telephone (home):
Telephone (work):
E mail address:
Category of membership:
Additional members at same address:
2^nd Person's Name:
3^rd Person's Name:
Payment Method:
Date:	Month: Year:
Signed:	____________________________

I wish to join the London Society and enclose my payment by cheque (payable to "The London Society") or Banker's Order. I agree to my details of membership being processed by computer for the purposes of membership administration as defined in the Data Protection Act 1998.

Please now print ([ctrl]+P often does the trick) this form, sign it and post (with cheque or completed Banker's Order) to: -

The Hon. Secretary, The London Society, Mortimer Wheeler House, 46 Eagle Wharf Road, London N1 7ED	It would greatly help the Society if you are able to complete: - * the Banker's Order to automatically pay your subscription. * the Gift Aid Declaration if you are a UK taxpayer.

TheLondonSociety

Application Form

The
London
Society