Newcomen Society

Application for membership of the Newcomen Society

Please print out this application form and return it, with your cheque or credit card details, to the address below

Subscription rates (GB pounds sterling, as of 1st October 2008)
UK Individual Member - with Transactions	Ł51	Overseas Individual Member - with Transactions	Ł60
UK Student Member, under 23	Ł15	Overseas Student Member under 23	Ł15

I would like to become a member of the Newcomen Society

Signed:
Date:

PERSONAL DETAILS

Title: Forename(s):

Surname:
Date of birth:
Academic or professional qualifications:
(No formal qualifications are required for membership)
Business or profession:
Address:

Postcode: Home tel:
Work tel: Mobile:
Fax: Email:
How did you hear about the Society?:

MAIN AREAS OF INTEREST (please tick those that apply)

Railways / canals / transport Civil / structural engineering
Naval / marine Electrical / electronic engineering
Computing Mining / metallurgy
Mills and millwork Other (please give details below)

INDIVIDUALS:
Please complete this form and send to:
The Executive Secretary, The Newcomen Society,
The Science Museum, London SW7 2DD.
(Tel/Fax: 020 7371 4445) LIBRARIES AND INSTITUTIONS:
Please contact:
Maney Publishing
(Customer Sales and Service Department)
Suite 1C, Joseph's Well, Hanover Walk,
Leeds LS3 1AB, UK
Tel: +44 (0)113 243 2800. Fax: +44 (0)113 386 8178

PAYMENT DETAILS

I enclose a cheque for Ł................

Or please debit my Debit/Visa/Mastercard account with the sum of Ł.............
My card number is:

Card expiry date:

Card security number:

Signed:

Date:

Please remember to enclose payment of your first subscription with this application form.

Title:	Forename(s):
Surname:
Date of birth:
Academic or professional qualifications: (No formal qualifications are required for membership)
Business or profession:
Address:


Postcode:	Home tel:
Work tel:	Mobile:
Fax:	Email:
How did you hear about the Society?:

	Railways / canals / transport	Civil / structural engineering
	Naval / marine	Electrical / electronic engineering
	Computing	Mining / metallurgy
	Mills and millwork	Other (please give details below)

INDIVIDUALS: Please complete this form and send to: The Executive Secretary, The Newcomen Society, The Science Museum, London SW7 2DD. (Tel/Fax: 020 7371 4445)		LIBRARIES AND INSTITUTIONS: Please contact: Maney Publishing (Customer Sales and Service Department) Suite 1C, Joseph's Well, Hanover Walk, Leeds LS3 1AB, UK Tel: +44 (0)113 243 2800. Fax: +44 (0)113 386 8178

PAYMENT DETAILS I enclose a cheque for Ł................ Or please debit my Debit/Visa/Mastercard account with the sum of Ł............. My card number is: