Application/renewal form: PLEASE WRITE CLEARLY
EITHER
I am a new member OR
I am renewing my membership
Please enrol me as a member of the Galpin Society for the year beginning 1 April 2015,
to include Journal 69 to be published in the Spring of 2016.
Name: [Mr/Mrs/Miss/Ms/Dr/
] _____________________________________
Address: _______________________________________________________________
______________________________________________________________________
______________________________________________________________________
email address: __________________________________________________________
Please include my email address in the membership list
website address: ________________________________________________________
Please add a link to my website from The Galpin Society website
*Students only* Tutor’s signature ___________________________________________
*Under-25s only* Date of birth ____________________________________________
PAYMENT
UK
Outside UK
Individual member:
£30
£36
Institution:
£40
£46
Student/Under-25:
£15
£18
Joint members:
£32
£38
I enclose a UK cheque for £ ________________ made payable to the Galpin Society
OR
Please email me details for paying direct into the Galpin Society bank account
OR
I will pay via PayPal after I have received my membership number
Please send the completed form to:
Maggie Kilbey, GS Administrator, 37 Townsend Drive, ST ALBANS, Herts, AL3 5RF, UK
email: [email protected]