APPLICATION FOR MEMBERSHIP

Categories of membership and subscriptions

Ordinary (Individual) members
£15.00

Joint Members
£17.00

Student Members (do not receive Transactions)
£6.00

Institutional members
£19.50

Affiliated Local Society members
£15.00

Please enroll me/us as an Ordinary/Joint/Student/Institutional/Local Society (delete as appropriate) Member of the London and Middlesex Archaeological Society.

Personal details (please complete in Block Capitals)

Name

________________________________________

Contact Name (for affiliated local society membership/institutional membership)

________________________________________

Email (Please supply your email if you would like to receive further news about our lectures and conferences)

________________________________________

Address

________________________________________

________________________________________

________________________________________

Post/Zip code

__________________

Occupation

________________________________________

Declaration under the Data Protection Act.

I consent to this personal data being held on computer, on the understanding that it will be used solely by the Society and will not be divulged to any other person or organisation.

Please tick here: ______

Signed

__________________________________

Date

__________________________________

Registration

Please return this form, together with £ ______ (enter amount) in payment of your first year’s subscription to:

Hon. Membership Secretary
London & Middlesex Archaeological Society
c/o The Museum of London
150 London Wall
LONDON
EC2Y 5HN

Cheques/Postal Orders/International Money Orders in Pounds Sterling ONLY please, made payable to The London and Middlesex Archaeological Society