MEMBERSHIP FORM

I/we* wish to join the Sorby Natural History Society of Sheffield and undertake to abide by the Rules and Constitution of the Society.
A cheque/postal order* made payable to The Sorby Natural History Society is enclosed for the first annual subscription of (tick as appropriate):
£10.00	_____ (Individual Membership)
£12.50	_____ (Household Membership)
£5.00	_____ (Junior/Student Membership)
Name(s)	____________________________________________________________________
Address	____________________________________________________________________
	____________________________________________________________________
	____________________________________________________________________
	____________________________________________________________________
	____________________________________________________________________
	Please be sure to include your postcode.
Telephone	______________________________
E-mail	______________________________
Interests	____________________________________________________________________
	____________________________________________________________________
	____________________________________________________________________
Where / how did you hear about Sorby?	____________________________________________________________________

(* delete as applicable)

Please return this form with your payment to:

The Sorby Natural History Society
c/o 159 Bell Hagg Road
Sheffield
S6 5DA
England

V4 (10/06) - http://www.sorby.org.uk