BACS - MEMBERSHIP FORM

I WISH TO APPLY TO BECOME A MEMBER OF BACS:

TITLE

FIRST NAME

SURNAME (FAMILY)

SURNAME (GIVEN)

EMAIL ADDRESS

TELEPHONE NO INCLUDING CODE

MAILING ADDRESS

POSTCODE

INSTITUTIONAL AFFILIATION (IF ANY)

DISCIPLINE OR ACADEMIC INTEREST

TYPE OF MEMBERSHIP:

REGULAR		CURRENTLY £30 PER YEAR
FAMILY		CURRENTLY £40 PER YEAR
CORPORATE		CURRENTLY £100 PER YEAR
STUDENT		CURRENTLY £8 PER YEAR
RETIRED		CURRENTLY £20 PER YEAR

PLEASE SELECT ONE OF ABOVE MEMBERSHIP TYPES

PAYMENT METHODS

I have completed the Standing Order Form / Direct Debit Mandate for
continuing annual membership until otherwise notified and will send to BACS by post.

I will be sending BACS a cheque by post for the required fee for 1 year membership only