BACS - MEMBERSHIP FORM

I WISH TO APPLY TO BECOME A MEMBER OF BACS:

TITLE

FIRST NAME

SURNAME (FAMILY)

EMAIL ADDRESS

TELEPHONE NO INCLUDING CODE

MAILING ADDRESS

POSTCODE

INSTITUTIONAL AFFILIATION (IF ANY)

DISCIPLINE OR ACADEMIC INTEREST

TYPE OF MEMBERSHIP:

PLEASE SELECT ONE OF ABOVE MEMBERSHIP TYPES

PAYMENT METHODS

Please send me a Standing Order Form for continuing annual membership

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