TO JOIN the Martineau Society if you live in the USA, please complete the form below, and send to the treasurer:
Gaby Weiner, 27 East Street, Lewes, East Sussex BN7 2LJ, UK
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To Gaby Weiner, 27 East Street, Lewes, East Sussex BN7 2LJ, UK
WE/I/this Institution would like to enrol in The Martineau Society
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(capitals please):
Name
........................
Address
........................
.........................
.........................
Zip/Postcode
..........................
Email
..................
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Annual subscription rates:
Institution 75 US Dollars per year
Individual 32 US Dollars per year
Concession (student/senior) 15 US Dollars per year
Life member (individual) 320 US Dollars, one-off payment
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Tick as appropriate:
I have transferred the sum electronically to: NatWest bank, North Walsham Branch, 9 St Nicholas Court, North Walsham NR28 9YY (sort code: 60-15-54, account no. 14082748) OR
I enclose cheque, payable The Martineau Society, for £
............... (or dollar equivalent)
I/We have no objection to my name/our names and addresses, as given on this form, being added to a database
which will be confidential to the society.
Signature
......... Date
.......................