Stamford geological society membership application form

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APPLICATION FOR MEMBERSHIP I wish to become a member of the Stamford and District Geological Society NAME ADDRESS

POST CODE TELEPHONE NO

MOBILE NUMBER

EMAIL ADDRESS The annual subscription is £10 individual; £15 family (two adults plus children);Students in full time education £3 Visitors to lectures are £3.The subscription runs from September the 1st to August the 31st.Your membership will include a FREE quarterly subscription too the Deposits Geological Magazine. Field Trips applicable to members only.Please return this form too: Miss. Sheila Martin, 1 Beverstone, Orton Brimbles, Peterborough, PE2 5YN.With a cheque or postal order payable to Stamford and District Geological Society :For more information please contact: membership@stamfordgeolsoc.org.uk

SIGNATURE

FOR OFFICE USE ONLY FEE PAID APPROVED BY DATE

DATE


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