Part 1  
Application for individual membership
Title    
Surname    
First name(s)    
Organisation & Address    
Job title  
'Phone number (work)    
'Phone number (mobile)    
E-mail address   
To save postage and printing, we will communicate with you by email.

Please tick the box if you would prefer to be contacted by post        [  ]
Mailing address
if different from above
 
Membership category applied for
Total amount enclosed
Individual @ £30.00
  £ ........................................
Unwaged Student/Retired @ £18.00