Application for Membership of Conchological Society of G.B. & Ireland
This form is for you to print and post. It cannot be submitted online

Title		Initials
Surname
Address
			Postcode
Country		Email address

Molluscan Interests (please underline all that apply)

British marine	Foreign marine	British non-marine
Foreign non-marine	Conchological books	Fossils
Diving	Photography	Mollusc captive rearing
General malacology including genetics and physiology	Conchological poetry and prose	Conservation (including ecology and pollution)
Applied Conchology/conchologia (e.g. snail or shell ornaments, shell money, cooking, decoration, shells on stamps, shell craft, etc)

Rates of subscription effective from 1st. January 2006
Tick the type of membership you require.

Full membership	£33.00
Family membership	£35.00
Student (in full time education)	£15.00
Institutional (UK address)	£47.00
Institutional (Overseas)	£50.00

                      Please complete the above form and send it with your remittance to :
The Conchological Society, 35 Bartlemy Road, Newbury,Berks RG14 6LD  UK

Payment must be by sterling cheque drawn on a UK bank or by a direct sterling payment made in favour of The Conchological Society of Great Britain and Ireland to the National Westminster Bank plc, Bolton Branch, PO Box 2, 24 Deansgate, Bolton Lancs BL1 1BN, UK. quoting: IBAN GB12 NWBK 0130 9906 5238 46: BIC NWBK GB2L.

You may also pay by credit card online by using this logo.