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APPLICATION FOR MEMBERSHIP OF THE MALACOLOGICAL SOCIETY OF LONDON
I wish to apply for Ordinary*/Student* Membership (*delete one).
I enclose a cheque (payable to "The Malacological Society of London") for my first annual subscription.
Web form V1

Title......................... Name....................................................................................
Department:.............................................. Institution:............................................
Street........................................................ City......................................................
Post Code/Zip........................................... Country..................................................
Telephone................................. Fax............................... Email...............................
Malacological interests............................................................................................
Signature.................................................... Date....................................................

For student membership: Confirmation of student status from Supervisor/Advisor:

Name....................................................... Signature...............................................

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A version of this form in WORD format is available here.

Please send the completed form and payment to the Membership Secretary:
Dr R. Cook,
School of Life Sciences,
Kingston University,
Penrhyn Road,
Kingston upon Thames,

Surrey,
KT1 2EE,
UK

Tel UK(44) +20 8547 2000 ext 2901
Fax UK(44) +20 8547 7562
Email: R.Cook@kingston.ac.uk

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