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: