Membership Application Form

As this form requires the signature of one proposer, it is not provided as an on-line form. Instead, print this page, complete, and return by post.

NAME (& TITLE) .........................................................................................

PROFESSIONAL ADDRESS.......................................................................

.........................................................................................................................

.........................................................................................................................

.........................................................................................................................

TELEPHONE ................................................................................................

FAX ................................................................................................................

E-MAIL .........................................................................................................
 
 

MEMBERSHIP - FULL / STUDENT*
* delete as appropriate. The fee is £15 for students and £25 for full members.

PERSONAL RESEARCH INTERESTS

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......................................................................................................................

......................................................................................................................
 


If you wish, you can avoid the need for writing cheques by completing the following form.

BANKER'S ORDER FORM

Date...........................

To...............................................................................................Bank Limited
(Full Address)...............................................................................................................
.....................................................................................................................................
.....................................................................................................................................

Please pay annually on 1st January, starting from 2006 , the sum of

* £25 (Full and Corresponding Members)

* £15 (Student Members) (*delete as appropriate)

 until this order is revoked, to:

The British Society of Protist Biology, Account No. 0212081,
Lloyds TSB, (Sort Code 30-97-71)
Sloane Square branch,
31 Sloane Square,
London,
SW1W 8AG.

PLEASE REVOKE ANY PREVIOUS ORDER TO THIS SOCIETY.

Signed ..............................................................................................................

Name (Block Capital) ......................................................................................

Address ............................................................................................................
............................................................................................................................
............................................................................................................................

Account Number ..............................................................................................
 
 

Please return these forms to the Treasurer:

Martin Carr
School of Applied Sciences,
University of Huddersfield,
Huddersfield,
HD1 3DH