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We hope to add facilities for joining on-line at some point, but for the moment, please print-out and complete both parts of the form below (it is also available for download as an Adobe Acrobat (PDF) file).
Send the completed form with either a cheque or money order (made out to “The Society for the History of Natural History”) or your credit card details to:
The Secretary
Society for the History of Natural History
c/o The Natural History Museum
Cromwell Road
London SW7 5BD
UK
Please complete both parts of the form using capital letters
Part 1: Personal details |
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| Name |
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| Title (Prof/Dr/Mr/Ms/Mrs/Miss/other) |
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| Address |
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| I apply for membership of the Society as indicated and will abide by the Rules if elected. Please indicate as appropriate. |
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| Signature (For dual membership both applicants must sign) |
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| Date |
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| Associate Members only: I confirm that I am under 30 years of age. |
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| Signature |
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| Date |
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Part 2: Payment details |
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EITHER: I enclose a cheque made out to “The Society for the History of Natural History” |
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for £ |
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OR: The following
credit/debit cards are accepted. |
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| Please charge my credit/debit card with the amount of £ |
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Please note: this sum must be in sterling although it will appear on your statement in your local currency. |
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Card Type: |
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Card Number: |
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Valid from: (month/year) |
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Expiry date: (month/year) |
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Issue number (Switch only) |
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| Signature: |
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| Name and address (as per credit/debit card holder): |
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Name: |
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| Address |
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| If the Society's publications etc. are to be sent to a different address, please specify. This is essential for credit/debit card users. |
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| Delivery address: |
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Send to: The Secretary, Society for the History of Natural History, c/o The Natural History Museum, Cromwell Road, London SW7 5BD, UK. |
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This
form is also available for download as an Adobe Acrobat
(PDF) file.
Payment may also be made by cheque, direct to our bank
or by Girobank (Account No. 572325908) |
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© SHNH 16/12/02
