Postal Microscopical Society



Application for membership.



Please complete the form below, using BLOCK CAPITALS, and return it , with the appropriate fee to the Secretary;



Mr M Samworth, 6 Moorfield Bungalows, Scotton, Catterick Garrison, North Yorkshire DL9 3ND.



Title:                Forenames:            

Surname:                            Age (if under 21):



Address:









Postcode:            Telephone No. and code;



Interests:









Occupation and Microscopical experience: (optional)





I wish to apply for off-circuit membership/on-circuit membership (delete as appropriate).





I agree to the above information being kept on electronic datafile, for use only within the Postal Microscopical Society.
I agree to abide by the rules of the society.



Signed:                                  Date:



Applicants less than 18 years old must have this form checked and signed by a parent or guardian, who agrees to full
responsibility for property whilst in the hands of the above applicant.



Signed:                                  Date: